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Compliance Analyst
4 weeks ago
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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