Note: The job is a remote job and is open to candidates in USA. Molina Healthcare is a leading organization in the healthcare sector, and they are seeking an Analyst for Compliance to support compliance activities. The role involves ensuring adherence to regulatory requirements, managing compliance incidents, and leading compliance-related projects.
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
Skills
- 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
- Certified in Healthcare Compliance (CHC)
- Experience with risk assessment methodologies
- Knowledge of internal control frameworks
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
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