Medicare Compliance Analyst

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JOB DESCRIPTION

Job Summary

Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities.

KNOWLEDGE/SKILLS/ABILITIES

The Compliance Analyst position is primarily responsible for Medicare Oversight.

Provide regulatory expertise to the Organization: both State and Federal

Have working knowledge of federal and state guidelines pertaining to Medicare Advantage (MA) products.

Perform internal MA Compliance Reporting.

Perform internal monitoring.

Detailed oriented to conduct thorough research.

Recommend applicable corrective action(s) to business partners.

Process improvement driven.

Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.

Lead regularly scheduled business meetings.

Interpret and analyze Medicare and Medicaid communications.

Review and interpret internal dashboards for outliers and deeper dive research when applicable.

Lead projects to achieve compliance objectives.

Interpret and analyze State and Federal Regulatory rules, manuals and revisions.

Interact with internal stakeholders via verbal and written communication.

Ability to work independently and set priorities.

Foster an environment of open communication with business partners.

EXPERIENCE

2-4 years’ related compliance work experience

Exceptional communication skills, including presentation capabilities, both written and verbal.

Excellent interpersonal communication and oral and written communication skills.

High level Interaction with Leadership.

Writing Policy & Procedures

Project Management experience is highly preferred.

REQUIRED EDUCATION :
Bachelor’s degree and/or equivalent combination of relevant education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :
2- 4 years’ experience in compliance related work

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :
PREFERRED EDUCATION :
PREFERRED EXPERIENCE :
1-3 years’ experience in the health care industry

Managed Care Experience

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.
Pay Range: $77,969 - $116,835 / ANNUAL

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