Manager, Compliance (Marketplace)

Job Description

Job Summary

Provides leadership and expertise to help facilitate compliance with applicable statutes, contractual requirements, policies and procedures to ensure enterprise compliance. Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business’ accountability for compliance by overseeing, follow-up and resolution of investigations.

 

Job Duties

• Assists with implementation and day-to-day operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the enterprise while ensuring compliance with governmental requirements.
• Manages the day-to-day activities, including management and oversight of Compliance Analysts. Develops a team focused  on meeting and exceeding established performance targets. Targets may be based upon plans, federal or state requirements as dictated.
• Spearheads development and implementation of compliance policies and procedures and training programs for the Molina enterprise.
• Oversees and provides direction of site visits for regulatory audits and coordinates corrective action plan, as needed.
• Investigates and resolves compliance problems, questions, or complaints received internally or from customers/agencies.
• Provides input and representation on key compliance initiatives, meetings, and committees. Stays abreast of industry and compliance trends; recommends and implements changes to internal company processes as needed.

 

Job Qualifications

REQUIRED EDUCATION:

Bachelor’s Degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

6+ years of experience with compliance, oversight, & government relations.

2+ years of experience leading a team.

PREFERRED EDUCATION:

Masters Degree preferred; will consider previous experience in health plan setting in government programs management (Contract Manager)

PREFERRED EXPERIENCE:

8+ years of experience with compliance, oversight, government relations.

4+ years of experience leading a team.

 

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

 

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.