Compliance Auditor (Must Reside in MA)

Job Summary

Establish a specifically designed compliance program that effectively prevents and / or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations.

Knowledge / Skills / Abilities

• Performs on-going compliance audits utilizing as necessary, state evaluation tools relating to audit / monitoring activities.
• Identifies and defines audit scope and criteria, reviews and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified.
• Provides comprehensive advice to assigned department regarding compliance risks with respect to Federal and State regulations and contract provisions.
• Provides significant input during the annual risk assessment and audit planning processes
• Assists with monitoring activities involving the effective execution of corrective action requirements imposed by state or federal regulatory agencies for contract deficiencies.
• Participates in Joint Operating Committees (JOCs) to share audit insights and support strategic compliances initiatives.
• Performs occasional site visits to material subcontractors to validate compliance and operational practices.

Job Qualifications

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

1-3 years

Preferred Education

Bachelor's degree in health care related area.

Preferred Experience

3-5 years

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.

Pay Range : $57,419 - $111,967 / ANNUAL

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