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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

Manager, Compliance Practices Oversight (Remote)

Molina Healthcare Covington, Kentucky; Lexington-Fayette, Kentucky; Grand Rapids, Michigan; Miami, Florida; Madison, Wisconsin; Iowa City, Iowa; Des Moines, Iowa; Boise, Idaho; Everett, Washington; Washington; Milwaukee, Wisconsin; Nebraska; Lincoln, Nebraska; Santa Fe, New Mexico; Bowling Green, Kentucky; Michigan; Phoenix, Arizona; Yonkers, New York; Austin, Texas; Cincinnati, Ohio; Columbus, Ohio; Caldwell, Idaho; Meridian, Idaho; West Valley City, Utah; Provo, Utah; Layton, Utah; Warren, Michigan; Omaha, Nebraska; Las Cruces, New Mexico; Roswell, New Mexico; New Mexico; Ann Arbor, Michigan; Rochester, New York; Chandler, Arizona; Tampa, Florida; Dallas, Texas; San Antonio, Texas; Columbus, Georgia; Sioux City, Iowa; Kentucky; Orem, Utah; Kenosha, Wisconsin; Grand Island, Nebraska; Scottsdale, Arizona; New York; Akron, Ohio; Florida; Fort Worth, Texas; Utah; Iowa; Kearney, Nebraska; Owensboro, Kentucky; Detroit, Michigan; Macon, Georgia; Georgia; Cleveland, Ohio; Houston, Texas; Idaho; Rio Rancho, New Mexico; Mesa, Arizona; Tucson, Arizona; St. Petersburg, Florida; Atlanta, Georgia; Spokane, Washington; Ohio; Dayton, Ohio; Vancouver, Washington; Green Bay, Wisconsin; Bellevue, Nebraska; Buffalo, New York; Jacksonville, Florida; Savannah, Georgia; Tacoma, Washington; Davenport, Iowa; Texas; Idaho Falls, Idaho; Racine, Wisconsin; Albuquerque, New Mexico; Louisville, Kentucky; Sterling Heights, Michigan; Syracuse, New York; Albany, New York; Orlando, Florida; Salt Lake City, Utah; Augusta, Georgia; Bellevue, Washington; Cedar Rapids, Iowa; Nampa, Idaho; Wisconsin Job ID 2031077
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Job Description


Job Summary

The Compliance Practices Oversight Manager serves as a liaison between the Compliance department and the Sales and Marketing functional departments and is the subject-matter-expert (SME) for guidance on Content Compliance needs and content submission processes for regulatory needs. This team supports compliance audits, implementing corrective action plans (CAPs), supporting legal requirements and needs, and provides metrics/KPI’s on compliance, contract and policy requirements.
The qualified candidate will have a breadth of experience across both managed care operations functions and execution of compliance practices. 

Position Scope

• Legal and Compliance support services: Works closely with the Legal, Government Contracts and Compliance departments to ensure proper interpretation of new rules and regulations.
• Rules and regulations: Ensure implementation of federal and state requirements for Medicare and Medicaid for health plan content and for assigned defined projects and programs.  Lead impact assessments and define work plans to ensure compliance when policies and regulations change. Lead the department in ongoing work related to policy and procedure documentation, revision, and maintenance. 
• Internal/external audits: Collect and validate data/sample/documentation requests; review preliminary findings with stakeholders and prepare/deliver responses.
• CAPs: Work with SMEs to document the CAP and ensure resolution; lead the team and track deliverables to ensure timely
• KPI’s: Report on department policy and compliance KPIs. Manage the strategic direction for the Compliance Practices Oversight team, ensuring the Marketing team is enabled to achieve and maintain consistent compliance across all requirements.
• Leadership: Lead a team of people. Establish the strategic direction, mission, and vision for the Compliance Practices Oversight team, ensuring that Marketing functions are enabled to achieve and maintain consistent compliance across all requirements.

Knowledge/Skills/Abilities

• Establish the strategic direction, mission, and vision for the Compliance Practices Oversight team, ensuring that Sales functions are enabled to achieve and maintain consistent compliance across all requirements
• Organize and lead the team to meet or exceed department compliance objectives
• Demonstrate facilitation, liaison, and negotiation skills to build consensus among diverse stakeholders
• Strong analytical capability, and comprehension of complex topics, including engaging others in understanding key concepts and their relationships
• Support and motivate others across Sales to produce required deliverables and consistently meet deadlines
• Ability to assess deliverables produced by others across Sales for accuracy and sufficiency, then provide effective feedback to ensure consistent quality 
• Maintain and enhance industry and company knowledge regarding the key compliance practices outlined in the Position Scope section of this document
• Serve as a resource and subject matter expert for compliance practices in support of all Sales functions 
• Lead in the collection, consolidation, and communication of reporting data and metrics relative to each of the compliance practices

Job Qualifications

REQUIRED EDUCATION:

BA/BS or equivalent experience

REQUIRED EXPERIENCE:

• 5+ years experience with managed healthcare operations
• 3-5 years process development/improvement experience
• 3+ years people leadership
• Strong analytical skills
• Strong problem-solving and critical thinking skills
• Highly organized and detail oriented with proof-reading and quality control skills
• Strong interpersonal, written and verbal communication skills; ability to communicate and facilitate communication with individuals at various levels within the organization and with external vendors
• Strong technical skills using Microsoft Applications (i.e. Outlook, Word, Excel, and PowerPoint) and other databases and tools as needed
• Previous experience working with the Centers for Medicare and Medicaid Services (CMS) Health Plan Management System (HPMS)

PREFERRED EDUCATION:

Graduate studies

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, SixSigma, or equivalent certification

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: $80,412 - $188,164 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 04/03/2025

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