Program Coordinator, Experienced- (Operations Audit Oversight)

Your Role

The Operations Audit Oversight team partners with external audit firms, regulators, and internal stakeholders to ensure compliance through robust audit execution and oversight across the Claims Organization. The team supports required audits, conducts data-driven claim reviews, identifies root causes, and proactively strengthens operational integrity. The Program Coordinator, Experienced will report to the Senior Manager, Claims. In this role, you will contribute to critical oversight and regulatory alignment by supporting MHPAEA (Mental Health Parity and Addiction Equity Act) monitoring efforts. To help ensure claims meet parity standards, collaborate with internal teams to evaluate compliance, and drive initiatives that support fair and equitable access to behavioral health services.

Your Work

In this role, you will:

• Be responsible for strategic alignment and integration across projects/programs, from initiation through delivery, in support of business unit process and administrative efficiency
• Define projects required to support programs and partners to ensure their implementation on time, within budget and with benefits realized
• Participate cross-functionally in business planning to support business unit strategy
• Be responsible for large/complex projects/programs
• Exercise independent judgement in developing methods, techniques and evaluation criterion for obtaining results   

• Manage compliance monitoring efforts related to MHPAEA regulations and ensure claims are aligned with parity standards

• Lead the revision of policies and procedures in response to regulatory changes and support training initiatives across teams

• Oversee internal and external data reporting to track parity compliance, claims performance, and audit outcomes

• Collaborate across departments to resolve claims discrepancies and identify systemic opportunities for improvement

• Analyze claims data to proactively identify patterns and prevent future MHPAEA-related issues[MM1] 

Your Knowledge and Experience

• Requires a bachelor’s degree or equivalent experience

• Requires at least 3 years of prior relevant experience

• Requires strong analytical skills to investigate root causes of claims issues and assess upstream/downstream impacts

• Requires excellent communication skills with the ability to translate mental health parity and claims concepts for varied audiences

• Requires proficiency in MS Office applications, especially Excel, to perform data-driven claims analysis

• Working knowledge of Facility and Professional behavioral health claims processing and experience with the FACETS system preferred

• Desired experience with reporting tools such as Business Objects or similar platforms[MM1] 

• Desired understanding of mental health benefit structures and parity-related requirements

• Desired ability to adapt to shifting priorities and contribute effectively in a dynamic environment