JOB DESCRIPTION

Job Summary

Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a centralized corporate function supporting compliance activities at individual state health plans. The Compliance Analyst position is a field based auditor position with up to 90% required travel within the New York Metropolitan area.

 KNOWLEDGE/SKILLS/ABILITIES

The Compliance Analyst position is primarily responsible for supporting the day to day operations and initiatives of the Compliance Department.

Performs Plan Required Reporting. Interpret and analyzes Medicare, Medicaid and Medicare Medicaid Plan Required Reporting Technical Specifications. Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports. Support management with New York State Assistor Concerns (Tracking/Action/Reporting) Conduct secret shop visits of Molina’s Sales team and sites to determine compliance with applicable rules and regulations and assess customer service. Assess Facilitated Enrollers, Managed Long Term Care and Medicaid Advantage Plus Representatives’ product knowledge. Document and submit detailed reports about the visits, including time, date, and staff interactions. Conduct telephonic audits of Molina’s Facilitated Enrollers. Conduct enrollment application audits. Ability to work independently and set priorities Excellent communication, observation and written skills. Strong analytical and reporting skills Must have a valid driver’s license and reliable transportation.

 

JOB QUALIFICATIONS

Required Education

BA/BS/BC degree Healthcare Administration or minimum equivalent employment experience of 4+ years, Health Care or related field required

Required Experience

4 years’ experience in health care industry in related field desired

Preferred Education

BA/BS/BC Healthcare Administration

Preferred Experience

4 years’ experience in health care industry in related field desired

Preferred License, Certification, Association

 

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.