Molina Healthcare

Analyst, Compliance - (Remote) Must have experience with Medicare Advantage and CMS regulatory requirements.(Remote) Must have experience with Medicare Advantage and CMS regulatory requirements.

Molina Healthcare$70K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 2+ years of compliance and/or audit experience or relevant education/experience
  • Familiarity with healthcare regulatory frameworks
  • Detail-oriented with strong documentation review skills
  • Proficient in data analysis and report generation
  • Ability to manage priorities independently
  • Experience collaborating in complex, cross-functional environments
  • Strong verbal and written communication skills

Responsibilities

  • Support daily operations of the compliance function
  • Provide technical expertise for regulatory inquiries
  • Facilitate required health plan compliance reporting
  • Analyze Medicare and Medicaid reporting requirements
  • Create and maintain KPI reports
  • Manage compliance incidents and corrective action plans
  • Lead complex compliance-related projects

Benefits

  • Comprehensive healthcare packages
  • Retirement savings plans
  • Professional development opportunities
  • Flexible work arrangements
  • Employee assistance programs
Full Job Description
Job Description

JOB DESCRIPTION Job Summary
Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or detect violation of applicable laws and regulations, and protect the business from liability, fraudulent or abusive practices.

Essential Job Duties
• Supports day-to-day operations/initiatives of the compliance function.
• Provides technical expertise for Molina interdepartmental regulatory and legislative interpretation inquiries.
• Facilitates health plan compliance-related required reporting.
• Interprets and analyzes Medicare, Medicaid and Medicare-Medicaid Plan (MMP) required reporting.
• Creates and maintains monthly and quarterly key performance indicator (KPI) reports.
• Supports the regulatory memorandum distribution process.
• Manages compliance incidents and related processes, including associated corrective action plans (CAPs).
• Responds to legislative inquiries/complaints (state/federal insurance regulators, congressional inquiries, etc.).
• Coordinates site visits for state/federal regulators.
• Leads large, complex compliance-related projects to achieve compliance objectives.
• Interprets and analyzes state and federal regulatory manuals, and supports revision process as needed.
• Interprets and analyzes federal and state rules and requirements for proposed and final rules.
• Coordinates comments relating to federal notices of proposed rulemaking.
• Manages Centers for Medicare and Medicaid Services (CMS) user access.

Job Requirements
• At least 2 years of compliance and/or audit-related experience, or equivalent combination of relevant education and experience.
• Knowledge of health care regulatory frameworks.
• Detail-oriented; skilled in documentation review.
• Data analysis skills, and ability to generate reports.
• Ability to work independently and set/manage priorities.
• Ability to collaborate in a cross-functional highly matrixed organization, and interact with internal/external stakeholders, including regulators.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.

Preferred Qualifications
• Certified in Healthcare Compliance (CHC).
• Experience with risk assessment methodologies.
• Knowledge of internal control frameworks. To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.

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.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It 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 Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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