Medicare Compliance Analyst

Compliance Analyst

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

The Compliance Analyst position is primarily responsible for Medicare Oversight.

Responsibilities include :

• 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 includes :

Required Education :

Required Experience / Knowledge, Skills & Abilities :

Required License, Certification, Association :

Required Education :

Preferred Experience :

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