Compliance Analyst (MI Health Plan) - REMOTE Eastern Time

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.
• Analyze data use critical thinking 
• 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. 
• Strong Microsoft Office experience to include intermediate to advanced experience in Excel

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.