Skip to main content

Search Jobs
Search

Let us search jobs for you based on the skills and experience listed in your LinkedIn profile.

Start Matching Jobs
close message

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.

Reporting Analyst, SIU-(Remote)

Molina Healthcare Green Bay, Wisconsin; Ann Arbor, Michigan; Iowa City, Iowa; Madison, Wisconsin; Columbus, Georgia; Iowa; Grand Island, Nebraska; Macon, Georgia; Provo, Utah; Ohio; Austin, Texas; Caldwell, Idaho; Everett, Washington; Albany, New York; Lincoln, Nebraska; Tacoma, Washington; Layton, Utah; Kenosha, Wisconsin; Fort Worth, Texas; Cleveland, Ohio; Kearney, Nebraska; New York; Boise, Idaho; Savannah, Georgia; Lexington-Fayette, Kentucky; Jacksonville, Florida; Columbus, Ohio; Roswell, New Mexico; Texas; Idaho; Nebraska; Utah; Vancouver, Washington; Florida; Houston, Texas; Omaha, Nebraska; Dallas, Texas; Dayton, Ohio; Salt Lake City, Utah; Cincinnati, Ohio; Tampa, Florida; Tucson, Arizona; Grand Rapids, Michigan; Washington; Michigan; Miami, Florida; Kentucky; Milwaukee, Wisconsin; Scottsdale, Arizona; Owensboro, Kentucky; St. Petersburg, Florida; Davenport, Iowa; Warren, Michigan; Chandler, Arizona; Akron, Ohio; San Antonio, Texas; Louisville, Kentucky; Albuquerque, New Mexico; Spokane, Washington; Nampa, Idaho; Covington, Kentucky; Meridian, Idaho; Las Cruces, New Mexico; Atlanta, Georgia; Augusta, Georgia; Rochester, New York; Wisconsin; Orlando, Florida; Bellevue, Washington; West Valley City, Utah; Sterling Heights, Michigan; Mesa, Arizona; Rio Rancho, New Mexico; Orem, Utah; Syracuse, New York; Des Moines, Iowa; New Mexico; Cedar Rapids, Iowa; Yonkers, New York; Detroit, Michigan; Georgia; Bellevue, Nebraska; Sioux City, Iowa; Racine, Wisconsin; Bowling Green, Kentucky; Phoenix, Arizona; Santa Fe, New Mexico; Buffalo, New York; Idaho Falls, Idaho Job ID 2031555
Apply Now

Job Description


Job Summary

Under direct supervision of the Manager, the Reporting Analyst, SIU supports a team in the Special Investigation Unit (SIU). The Reporting Analyst, SIU will ensures FWA referrals are logged, documented, assigned for investigation and appropriately reported to state and federal regulators. and/or law enforcement as appropriate. Ensures that appropriate information is timely and accurately gathered and reported to state and federal regulators as appropriate (monthly, quarterly and annually). Provide oversight of designated SIU tracking systems. Duties may include: performing peer reviews to ensure Reporting and Triage activities are timely, accurate and in compliance with requirements prescribed by Molina Healthcare Inc., coordination with other departments to mitigate and remedy FWA.

JOB DUTIES (Main duties & responsibilities of the role):

  • The position is responsible for creating regulatory reports specific to the SIU in support of contractual requirements, including reporting on overpayments identified and recovered; Tips/leads received; investigative case activity; any additional summary reports.
  • Interprets and analyzes state and federal regulatory rules, contracts, and other guidance to assess compliance and support building regulatory compliance audit procedures
  • At the direction of management, performs oversight audits and validation activities to ensure operational regulatory compliance with Federal and State laws and regulations, contract provisions, and internal policies and procedures
  • Supports the Special Investigations Unit (SIU) Manager, Director, and team in the general development of the Operational Oversight Program including, but not limited to, creating regulatory reports, FWA complaint intake triage, assigning complaints to staff as directed by management, and demonstrate compliance to regulatory requirements across all Molina Healthcare Plans 
  • Manage and produce their own inventory of regulatory reports.
  • May support health plans and MHI Business Owners with external regulatory audit requests including the completion of audit risk assessments, the preparation and submission of sample universes, and submission of SOPs, regulatory requests for information, training materials, and/or other evidence as part of regulatory audits. EX: DMHC, CMS active audits
  • Based on regulatory and contractual requirements, and in collaboration with Business Owners, Corporate Compliance, and other key stakeholders, develops and communicates audit scope, objectives, and timelines
  • May develop and analyze trend reports to ensure contractual and regulatory compliance and performance improvement standards and for identification of any training needs;
  • To avoid instances of non-compliance, the Reporting Analyst, SIU will ensure that MHI is meeting all regulatory reporting requirements for state and federal FWA notification.
  • Will ensure compliance with all Molina Health Plans through report creation and execution.
  • Serve as a backup to Sr Reporting Analyst.
  • Perform peer reviews to ensure reporting activities are timely, accurate and in compliance with requirements prescribed by Molina Healthcare.
  • Healthcare experience
  • Excel-Proficient
  • Healthcare Fraud Shield-preferred 

Job Qualifications

REQUIRED EDUCATION:

Associate Degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

Minimum 2 years experience in SIU, law enforcement, healthcare field or regulatory field

Minimum 1 years’ experience with regulatory reporting

PREFERRED EXPERIENCE:

• 2-4 experience working for a managed care organization

• 3-5 years experience in healthcare industry in related field desired (Regulatory, Compliance and Auditing)

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

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: $21.82 - $51.06 / HOURLY
*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: 05/06/2025

ABOUT OUR LOCATION

View Map

No recently viewed jobs.

View All Jobs

No saved jobs.

View All Jobs

Job Alerts

Sign up to receive automatic notices when jobs that match your interests are posted.

By uploading your resume you are not submitting an application for employment

Interested InSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

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