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Healthcare Services Operations Support Auditor
Molina Healthcare Idaho Falls, Idaho; Florida; Texas; Ohio; Savannah, Georgia; Nampa, Idaho; Green Bay, Wisconsin; Grand Rapids, Michigan; Sterling Heights, Michigan; Dallas, Texas; Meridian, Idaho; Warren, Michigan; Kenosha, Wisconsin; Roswell, New Mexico; Macon, Georgia; Vancouver, Washington; Scottsdale, Arizona; Georgia; West Valley City, Utah; Utah; St. Petersburg, Florida; Omaha, Nebraska; Iowa City, Iowa; Phoenix, Arizona; Madison, Wisconsin; Cincinnati, Ohio; Augusta, Georgia; Iowa; Nebraska; Boise, Idaho; Akron, Ohio; Lexington-Fayette, Kentucky; Tampa, Florida; Mesa, Arizona; Everett, Washington; Michigan; New Mexico; Bellevue, Nebraska; Jacksonville, Florida; Layton, Utah; Bowling Green, Kentucky; Buffalo, New York; Cedar Rapids, Iowa; Rochester, New York; Grand Island, Nebraska; Orlando, Florida; Milwaukee, Wisconsin; Owensboro, Kentucky; Sioux City, Iowa; Covington, Kentucky; Wisconsin; Davenport, Iowa; Cleveland, Ohio; Santa Fe, New Mexico; Albuquerque, New Mexico; Chandler, Arizona; Des Moines, Iowa; Houston, Texas; Spokane, Washington; Washington; Bellevue, Washington; Caldwell, Idaho; Tacoma, Washington; Ann Arbor, Michigan; Dayton, Ohio; Orem, Utah; Las Cruces, New Mexico; Salt Lake City, Utah; Columbus, Georgia; Atlanta, Georgia; Albany, New York; Austin, Texas; Idaho; New York; Racine, Wisconsin; San Antonio, Texas; Tucson, Arizona; Kearney, Nebraska; Miami, Florida; Detroit, Michigan; Yonkers, New York; Provo, Utah; Kentucky; Lincoln, Nebraska; Syracuse, New York; Louisville, Kentucky; Rio Rancho, New Mexico; Fort Worth, Texas; Columbus, Ohio Job ID 2033756JOB DESCRIPTION
Job Summary
Provides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements.
• Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
• Ensures auditing approaches follow a Molina standard in approach and tool use.
• Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrates professionalism in all communications.
• Adheres to departmental standards, policies, protocols.
• Maintains detailed records of auditing results.
• Assists healthcare services with developing training materials or job aids as needed to address findings in audit results.
• Meets minimum production standards related to non-clinical auditing.
• May conduct staff trainings as needed.
• Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
• At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
• Strong analytical and problem-solving skills.
• Ability to work in a cross-functional, professional environment.
• Ability to work on a team and independently.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $24 - $56.17 / 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 09/26/2025Job Alerts
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