Address
Form of work
SalarySalary
$28.72 - $45.95 Hourly
$59,739 - $95,582 Annually
This position is a Pay Band 75
Posting Details
THIS POSTING WILL BE USED FOR ONGOING RECRUITMENT AND MAY CLOSE AT ANY TIME. APPLICANT LISTS MAY BE SCREENED MORE THAN ONCE.
The OSI enforces New Mexico law on insurance matters, including consumer protections, review of insurance forms and rates for accuracy and fairness, and helps New Mexicans address insurance concerns. We oversee and regulate most kinds of insurance in New Mexico and we license the individuals and agencies that sell insurance in the state.
Why does the job exist?
This position will help implement of New Mexico's Mental Health Access Act passed during the 2023 legislative session and implementation of federal Mental Health parity law. The position will focus on implementation and oversight of behavioral Health Access laws related to insurers' Utilization Management practices, such as prior authorization requirements, retrospective and concurrent benefit review, step-therapy requirements, level of care decisions, and other insurer medical management technique limiting access to behavioral health benefits.
How does it get done?
- Procurement and management of contracts with Mental Health parity and behavioral Health Access experts;
- Oversight of queries and data calls issued to health insurance companies on behavioral benefits Utilization Management
- Investigation and tracking of complaints related to Utilization Management of behavioral health benefits;
- Generating internal and external reporting of implementation of laws impacting Utilization Management of behavioral health
- Tracking compliance and enforcement efforts;
- Advising on policy matters related to implementation of Utilization Management and behavioral Health Access laws;
- Track developments in behavioral health and Utilization Management laws at state and federal levels;
- Engage stakeholders such as providers, insurers, and health insurance consumers on implementation of behavioral health
Who are the customers?
The position is focused on consumer protections for individuals and families with commercial health insurance.
Ideal Candidate
- Background in providing or administering behavioral health services;
- Proficiency in health insurance concepts;
- Background in project management;
- background or education in public health;
Minimum Qualification
Bachelor's Degree and five (5) years program administration or project management in areas related to the purpose of the position. Substitutions apply. See Substitution Table below.
Substitution Table
These combinations of education and experience qualify you for the position:
- Education and years of experience must be related to the purpose of the position.
- If Minimum Qualification requires a specific number of "semester hours" in a field (e.g. 6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications. No substitutions apply for semester hours.
Employment Requirements
Must possess a valid New Mexico Driver's license, a current defensive driving course certification from the State of New Mexico or must pass Defensive Driving Course Certificate within six months of the date of hire as a condition of continued employment.
Working Conditions
Work is performed in an office setting with extensive exposure to Visual/Video Display Terminal (VDT), personal computer, laptop, printer, calculator, hole-punch, cellphone, copy machine, scanner, keyboard and telephone usage.
Supplemental Information
Benefits:
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Agency Contact Information: Viara Ianakieva (505) 508-9073 Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is not covered by a collective bargaining agreement.
