About the position Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or detect violation of applicable laws and regulations, and protect the business from liability, fraudulent or abusive practices.

Responsibilities

• Supports day-to-day operations/initiatives of the compliance function.
• Provides technical expertise for Molina interdepartmental regulatory and legislative interpretation inquiries.
• Facilitates health plan compliance-related required reporting.
• Interprets and analyzes Medicare, Medicaid and Medicare-Medicaid Plan (MMP) required reporting.
• Creates and maintains monthly and quarterly key performance indicator (KPI) reports.
• Supports the regulatory memorandum distribution process.
• Manages compliance incidents and related processes, including associated corrective action plans (CAPs).
• Responds to legislative inquiries/complaints (state/federal insurance regulators, congressional inquiries, etc.).
• Coordinates site visits for state/federal regulators.
• Leads large, complex compliance-related projects to achieve compliance objectives.
• Interprets and analyzes state and federal regulatory manuals, and supports revision process as needed.
• Interprets and analyzes federal and state rules and requirements for proposed and final rules.
• Coordinates comments relating to federal notices of proposed rulemaking.
• Manages Centers for Medicare and Medicaid Services (CMS) user access.

Requirements

• At least 2 years of compliance and/or audit-related experience, or equivalent combination of relevant education and experience.
• Knowledge of health care regulatory frameworks.
• Detail-oriented; skilled in documentation review.
• Data analysis skills, and ability to generate reports.
• Ability to work independently and set/manage priorities.
• Ability to collaborate in a cross-functional highly matrixed organization, and interact with internal/external stakeholders, including regulators.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.

Nice-to-haves

• Certified in Healthcare Compliance (CHC).
• Experience with risk assessment methodologies.
• Knowledge of internal control frameworks.

Benefits

• competitive benefits and compensation package