Job description

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. This position is supporting compliance operations for Molina's Texas Health Plan.

Knowledge/Skills/Abilities

The Compliance Analyst position is primarily responsibility for supporting the day to day operations and initiatives of the Texas Compliance function.

Provides technical expertise to regulatory & legislative interpretation inquiries.
Performs Plan Required Reporting as needed
Interpret and analyze Medicare, Medicaid and MMP Required Reporting Specifications.
Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
Manages compliance incidents management and related processes, including associated corrective action plans.
Provides technical expertise with Molina interdepartmental regulatory & legislative interpretation inquiries.
Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
Assists with the regulatory memo distribution process.
Leads large, complex projects to achieve compliance objectives.
Interprets and analyzes state and federal regulatory manuals and revisions.
Interprets and analyzes federal and state rules and requirements for proposed & final rules.
Ensure completion and delivery of audit deliverables, including tracking, reporting and review of audit items to meet regulatory requests.
Enter, track, manage and report on Corrective Action Plans, both internal and regulatory.
Ability to work independently and set priorities.

Job Qualifications

REQUIRED QUALIFICATIONS:

3-4 years’ related compliance work experience and/or credentials
Exceptional communication skills, including presentation capabilities, interpersonal skills and conflict resolution.
Excellent negotiation skills with exceptional interpersonal communication and oral and written communication skills.
Ability to maintain an independent and objective perspective.

Preferred Qualifications

BA/BS and/or CHC (Certified in Healthcare Compliance)

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: $77,969 - $95,000 / ANNUAL