Compliance Analyst - Long Beach, United States - Molina Healthcare

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    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.

    KNOWLEDGE/SKILLS/ABILITIES

    The Compliance Analyst position is primarily responsibility for supporting the day to day operations and initiatives of the Compliance Department.
    • Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
    • Performs Plan Required Reporting.
    • Interpret and analyzes Medicare, Medicaid and MMP Required Reporting Technical Specifications.
    • Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
    • Support the management of the regulatory memo distribution process Ability to work independently and set priorities.
    • Manages compliance incidents management and related processes, including associated corrective action plans.
    • Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
    • Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
    • Assists with the regulatory memo distribution process.
    • Coordinates site visits for federal & state regulators.
    • 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.
    • Coordinates comments relating to federal notices of proposed rulemaking.
    • Manages user access to CMS.
    • Ability to work independently and set priorities.
    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

    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.