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Auditor, Compliance (Remote in FL)

Role overview

Qualifications

  • At least 2 years experience in audit and/or compliance, or equivalent combination of relevant education and experience.
  • Knowledge of relevant regulatory frameworks and compliance standards.
  • Understanding of internal control concepts and risk assessment methodologies.
  • Strong analytical and problem-solving abilities.

Responsibilities

  • Performs on-going compliance audits utilizing state evaluation tools.
  • Identifies and defines audit scope and criteria, reviews and analyzes evidence.
  • Provides comprehensive advice to assigned departments regarding compliance risks.
  • Assists with monitoring activities involving corrective action requirements.

Key facts

Other skills

  • Analytical Skills
  • Problem Solving
  • Detail Oriented
  • Communication
  • Microsoft Office

About the company

Molina Healthcare logo

Molina Healthcare

Health Insurance (Payers)

Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

JOB DESCRIPTION


Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk related to fraudulent or abusive practices.

Essential Job Duties


• Performs on-going compliance audits utilizing as necessary, state evaluation tools relating to audit/monitoring activities. 
• Identifies and defines audit scope and criteria, reviews and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified. 
• Provides comprehensive advice to assigned departments regarding compliance risks with respect to federal and state regulations and contract provisions. 
• Provides input and support during the annual risk assessment and audit planning processes. 
• Assists with monitoring activities involving the effective execution of corrective action requirements imposed by state or federal regulatory agencies for contract deficiencies.

Job Requirements


• At least 2 years experience in in audit and/or compliance, or equivalent combination of relevant education and experience. 
• Knowledge of relevant regulatory frameworks and compliance standards. 
• Understanding of internal control concepts and risk assessment methodologies. 
• Strong analytical and problem-solving abilities. 
• Attention to detail, and ability to manage multiple projects simultaneously. 
• Effective verbal and written communication skills. 
• Microsoft Office suite and applicable software program(s) proficiency.

Preferred Qualifications


• Experience in the health care industry. 



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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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