• Medicare Compliance Analyst

    Molina Healthcare (Dayton, OH)


    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.

    Pay Range: $77,969 - $116,835 / ANNUAL

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