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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

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.