Medicare Compliance Analyst

JOB DESCRIPTION

Job Summary

Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities.

KNOWLEDGE/SKILLS/ABILITIES

The Compliance Analyst position is primarily responsible for Medicare Oversight.

• Provide regulatory expertise to the Organization: both State and Federal
• Have working knowledge of federal and state guidelines pertaining to Medicare Advantage (MA) products.
• Perform internal MA Compliance Reporting.
• Perform internal monitoring.
• Detailed oriented to conduct thorough research.
• Recommend applicable corrective action(s) to business partners.
• Process improvement driven.
• Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.
• Lead regularly scheduled business meetings.
• Interpret and analyze Medicare and Medicaid communications.
• Review and interpret internal dashboards for outliers and deeper dive research when applicable.
• Lead projects to achieve compliance objectives.
• Interpret and analyze State and Federal Regulatory rules, manuals and revisions.
• Interact with internal stakeholders via verbal and written communication.
• Ability to work independently and set priorities.
• Foster an environment of open communication with business partners.

EXPERIENCE

• 2-4 years’ related compliance work experience
• Exceptional communication skills, including presentation capabilities, both written and verbal.
• Excellent interpersonal communication and oral and written communication skills. 
• High level Interaction with Leadership.
• Writing Policy & Procedures
• Project Management experience is highly preferred. 

REQUIRED EDUCATION: 

• Bachelor’s degree and/or equivalent combination of relevant education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 

• 2- 4 years’ experience in compliance related work

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: 

PREFERRED EDUCATION: 

PREFERRED EXPERIENCE: 

• 1-3 years’ experience in the health care industry 
• Managed Care Experience

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.