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 Analyst (Medicaid and MLTC Sales/ Marketing/ Retention Oversight) 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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Pay Range: $45,390.49 - $88,511.46 a year*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.