JOB DESCRIPTION

Job Summary

Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a centralized corporate function supporting compliance activities at individual state health plans. The Compliance Analyst position is a field based auditor position with up to 90% required travel within the New York Metropolitan area.

 KNOWLEDGE/SKILLS/ABILITIES

The Compliance Analyst position is primarily responsible for supporting the day to day operations and initiatives of the Compliance Department.

• Performs Plan Required Reporting.
• Interpret and analyzes 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.
• Ability to work independently and set priorities
• Excellent communication, observation and written skills.
• Strong analytical and reporting skills
• Must have a valid driver’s license and reliable transportation.

JOB QUALIFICATIONS

Required Education

BA/BS/BC degree Healthcare Administration or minimum equivalent employment experience of 4+ years, Health Care or related field required

Required Experience

4 years’ experience in health care industry in related field desired

Preferred Education

BA/BS/BC Healthcare Administration

Preferred Experience

4 years’ experience in health care industry in related field desired

Preferred License, Certification, Association

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: $62,400 - $106,214 / 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.