Description

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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.

  • Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
  • Performs Plan Required Reporting.
  • Interpret and analyzes Medicare, Medicaid and MMP Required Reporting Technical Specifications.
  • Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
  • Support the management of the regulatory memo distribution process Ability to work independently and set priorities.
  • Manages compliance incidents management and related processes, including associated corrective action plans.
  • Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
  • Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
  • Assists with the regulatory memo distribution process.
  • Coordinates site visits for federal & state regulators.
  • Leads large, complex projects to achieve compliance objectives.
  • Interprets and analyzes state and federal regulatory manuals and revisions.
  • Interprets and analyzes federal and state rules and requirements for proposed & final rules.
  • Coordinates comments relating to federal notices of proposed rulemaking.
  • Manages user access to CMS.
  • Ability to work independently and set priorities.

JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS:

  • 3-4 years related compliance work experience and/or credentials
  • Exceptional communication skills, including presentation capabilities, interpersonal skills and conflict resolution.
  • Excellent negotiation skills with exceptional interpersonal communication and oral and written communication skills.
  • Ability to maintain an independent and objective perspective.

PREFERRED QUALIFICATIONS:

  • BA/BS and/or CHC (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 – $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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