Compliance Specialist (REMOTE - NY ONLY - Travel Required)
About the positionResponsibilities• Perform Plan Required Reporting. • Interpret and analyze Medicare, Medicaid, and Medicare Medicaid Plan Required Reporting Technical Specifications. • Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports. • Support management with New York State Assistor Concerns (Tracking/Action/Reporting). • Conduct secret shop visits of Molina's Sales team and sites to determine compliance with applicable rules and regulations and assess customer service.• Assess Facilitated Enrollers, Managed Long Term Care, and Medicaid Advantage Plus Representatives' product knowledge. • Document and submit detailed reports about the visits, including time, date, and staff interactions. • Conduct telephonic audits of Molina's Facilitated Enrollers. • Conduct enrollment application audits. Requirements• BA/BS/BC degree in Healthcare Administration or equivalent employment experience of 4+ years in Health Care or related field required. • 4 years' experience in the health care industry in a related field desired.Nice-to-haves• Preferred education includes BA/BS/BC in Healthcare Administration. • Preferred experience includes 4 years' experience in the health care industry in a related field. Benefits• Competitive benefits and compensation package. Apply tot his job