Talent.com
Director, Compliance (Must reside in Massachusetts)

Director, Compliance (Must reside in Massachusetts)

Molina HealthcareAlbuquerque, NM, United States
5 hours ago
Job type
  • Full-time
Job description

Job Description

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

  • Responsible for oversight and management of Health Plan Compliance Directors for all compliance activities and serves as a resource on compliance issues. Provides leadership and expertise to help facilitate compliance with applicable statutes and policies.
  • Provides leadership to Health Plan Compliance Directors on training and education of compliance requirements. Provides specialized compliance education and training when necessary.
  • Enforces, as a representative of management, the Compliance Plan, Code of Conduct and Anti-Fraud Plan.
  • Establishes, at the direction of the AVP of Compliance or the AVP of the Corporate SIU an active relationship with third parties who have specific experience in conducting fraud and abuse investigations.
  • Prepares written reports to inform the AVP of Compliance, no less than quarterly, the status of activities pertaining to overall Health Plan compliance..

Job Qualifications

Required Education

Graduate Degree or equivalent combination of education and experience

Required Experience

7-9 years

Preferred Education

Master's Degree

Preferred Experience

10+ years

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.

#PJCorp

#LI-AC1

Pay Range : $111,893 - $227,679 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Director Compliance • Albuquerque, NM, United States

    Related jobs
    • Promoted
    Clinical Quality and Compliance Specialist

    Clinical Quality and Compliance Specialist

    UNM Medical Group, Inc.Albuquerque, NM, United States
    Full-time
    Clinical Quality and Compliance Specialist.Minimum $60,672 - Midpoint $75,840 •.Salary is determined based on years of total relevant experience. FTE (full time equivalent) or 40 hours per week.Less ...Show moreLast updated: 20 days ago
    • Promoted
    • New!
    Social Services Director

    Social Services Director

    Belen Meadows HC and Rehab CtrLos Trujillos, NM, US
    Full-time
    Overview : At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care indus...Show moreLast updated: 5 hours ago
    • Promoted
    Border Patrol Agent

    Border Patrol Agent

    U.S. Customs and Border ProtectionMountainair, NM, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    Director, Clinical Operations

    Director, Clinical Operations

    Molina HealthcareAlbuquerque, NM, United States
    Full-time
    The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.Directs all Clinical Contact Center operations. Implements direction and performa...Show moreLast updated: 17 days ago
    • Promoted
    Remote Litigation Attorney

    Remote Litigation Attorney

    TemPositionsRio Rancho, NM, United States
    Remote
    Full-time
    Hearing Representative - Special Education Claims.A prestigious government agency is addressing the backlog of special education claims in New York City to ensure timely and fair resolution of disp...Show moreLast updated: 30+ days ago
    • Promoted
    Community Behavioral Health Liaison (Field travel in Detroit, MI)

    Community Behavioral Health Liaison (Field travel in Detroit, MI)

    Molina HealthcareLos Lunas, NM, United States
    Full-time
    Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and substance use services and assists with implementi...Show moreLast updated: 17 days ago
    • Promoted
    Tax Director

    Tax Director

    Southern New Hampshire UniversityAlbuquerque, NM, United States
    Full-time
    Southern New Hampshire University is a team of innovators.Individuals who believe in progress with purpose.Since 1932, our people-centered strategy has defined us - and helped us grow a team that n...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Specialist, Critical Incidents

    Specialist, Critical Incidents

    Molina HealthcareRio Rancho, NM, US
    Full-time
    JOB DESCRIPTION Job SummaryProvides support for critical incident management activities, including provision of critical incident management referral support to members. Strives to ensure member pro...Show moreLast updated: 4 hours ago
    • Promoted
    Customs and Border Protection Officer

    Customs and Border Protection Officer

    U.S. Customs and Border ProtectionAlgodones, NM, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    Customs and Border Protection Officer - Experienced (GS9)

    Customs and Border Protection Officer - Experienced (GS9)

    U.S. Customs and Border ProtectionSandia Knolls, NM, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    Marine Interdiction Agent

    Marine Interdiction Agent

    U.S. Customs and Border ProtectionSedillo, NM, United States
    Full-time
    Air and Marine Operations (AMO), a component of U.Customs and Border Protection (CBP) offers those with Merchant Mariner Credentials the exceptional opportunity of a career in law enforcement worki...Show moreLast updated: 2 days ago
    • Promoted
    Air Interdiction Agent

    Air Interdiction Agent

    U.S. Customs and Border ProtectionMountainair, NM, United States
    Full-time
    Pilot CBP Air Interdiction Agent.Air and Marine Operations (AMO), a component of U.Customs and Border Protection (CBP), offers skilled Pilots interested in law enforcement an opportunity to work wi...Show moreLast updated: 2 days ago
    • Promoted
    Director - Claims

    Director - Claims

    Presbyterian Healthcare ServicesAlbuquerque, NM, US
    Full-time
    Director Of Claims And Encounters.The Director Of Claims And Encounters provides strategic leadership, fiscal accountability and operational excellence for the Presbyterian Health Plan (PHP) Claims...Show moreLast updated: 4 days ago
    • Promoted
    Remote Finance Director - AI Trainer

    Remote Finance Director - AI Trainer

    Data AnnotationRio Rancho, New Mexico
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...Show moreLast updated: 30+ days ago
    • Promoted
    Director, Client Acquisition

    Director, Client Acquisition

    ENGIE North America Inc.Corrales, NM, United States
    Full-time +1
    Remote, United States, Alabama | Remote, United States, Arizona | Remote, United States, Arkansas | Remote, United States, California | Remote, United States, Colorado | Remote, United States,...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Certified Occupational Therapist Assistant (COTA) - $1,349 to $2,032 per week in Clovis, NM

    Travel Certified Occupational Therapist Assistant (COTA) - $1,349 to $2,032 per week in Clovis, NM

    AlliedTravelCareersRio Rancho, New Mexico, US
    Full-time
    AlliedTravelCareers is working with CompHealth to find a qualified Certified Occupational Therapist Assistant (COTA) in Clovis, New Mexico, 88103!. CompHealth services are always free to you.Let us ...Show moreLast updated: 30+ days ago
    • Promoted
    Director, Clinical Systems

    Director, Clinical Systems

    Molina HealthcareLos Lunas, NM, United States
    Full-time
    Leads and directs a team supporting clinical systems.Responsible for provision of product ownership of clinical applications including design, development, implementation, and oversight of technolo...Show moreLast updated: 7 days ago
    • Promoted
    United States Customs and Border Protection Officer

    United States Customs and Border Protection Officer

    U.S. Customs and Border ProtectionLos Lunas, New Mexico, US
    Full-time +1
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 5 days ago