JOB DESCRIPTION
Job Summary
Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a centralized corporate function supporting compliance activities at individual state health plans.
KNOWLEDGE/SKILLS/ABILITIES
The Compliance Analyst position is primarily responsibility for supporting the day to day operations and initiatives of the Compliance Department.
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Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
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Performs Plan Required Reporting.
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Interpret and analyzes Medicare, Medicaid and MMP Required Reporting Technical Specifications.
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Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
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Support the management of the regulatory memo distribution process Ability to work independently and set priorities.
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Manages compliance incidents management and related processes, including associated corrective action plans.
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Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
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Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
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Assists with the regulatory memo distribution process.
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Coordinates site visits for federal & state regulators.
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Leads large, complex projects to achieve compliance objectives.
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Interprets and analyzes state and federal regulatory manuals and revisions.
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Interprets and analyzes federal and state rules and requirements for proposed & final rules.
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Coordinates comments relating to federal notices of proposed rulemaking.
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Manages user access to CMS.
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Ability to work independently and set priorities.
JOB QUALIFICATIONS
Required Education
BA/BS/BC degree Healthcare Administration or minimum equivalent employment experience of 4+ years, Health Care or related field required
Required Experience
4 years’ experience in health care industry in related field desired
Preferred Education
BA/BS/BC Healthcare Administration
Preferred Experience
4 years’ experience in health care industry in related field desired
Preferred License, Certification, Association
Certified in Healthcare Compliance
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
