Compliance Analyst

4 weeks ago


Long Beach, United States Molina Healthcare Full time
Job Description

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 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.
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