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Medicare Compliance Analyst
Medicare Compliance AnalystOhio Staffing • Cincinnati, OH, US
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Medicare Compliance Analyst

Medicare Compliance Analyst

Ohio Staffing • Cincinnati, OH, US
4 days ago
Job type
  • Full-time
Job description

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.

Knowledge / Skills / Abilities :

  • 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.
  • Preferred Education :

  • Master's degree.
  • Preferred Experience :

  • 1-3 years' experience in the health care industry.
  • Managed Care Experience.
  • 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.
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    Compliance Analyst • Cincinnati, OH, US

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