Analyst, Compliance

Molina Healthcare; Macon (GA); On-site; USD 77,000 - 117,000; Full time

Job summary

A national healthcare organization in Macon, Georgia is seeking a Compliance Specialist to support enterprise compliance operations. The role requires extensive experience in compliance, exceptional communication skills, and a BA/BS or CHC certification. Key responsibilities include managing compliance incidents, interpreting regulations, and producing performance reports. This position offers competitive compensation and is part of a strong benefits package.

Benefits

Competitive benefits and compensation package

Equal Opportunity Employer (EOE)

Qualifications

• 3-4 years’ related compliance work experience and/or credentials.
• Excellent negotiation skills with exceptional oral and written communication skills.
• Ability to maintain an independent and objective perspective.

Responsibilities

• Provide technical expertise to regulatory inquiries.
• Perform Plan Required Reporting.
• Interpret Medicare and Medicaid reporting specs.
• Create KPI reports.

Skills

Compliance work experience

Exceptional communication skills

Negotiation skills

Ability to work independently

Education

BA/BS and/or CHC (Certified in Healthcare Compliance)

Job description

Overview

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.

Responsibilities

• Provides technical expertise to Molina interdepartmental regulatory & legislative interpretation inquiries.
• Performs Plan Required Reporting.
• Interpret and analyzes Medicare, Medicaid and MMP Required Reporting Technical Specifications.
• Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
• Support the management of the regulatory memo distribution process Ability to work independently and set priorities.
• Manages compliance incidents management and related processes, including associated corrective action plans.
• Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
• Assists with the regulatory memo distribution process.
• Coordinates site visits for federal & state regulators.
• Leads large, complex projects to achieve compliance objectives.
• Interprets and analyzes state and federal regulatory manuals and revisions.
• Interprets and analyzes federal and state rules and requirements for proposed & final rules.
• Coordinates comments relating to federal notices of proposed rulemaking.
• Manages user access to CMS.
• Ability to work independently and set priorities.

Qualifications

• 3-4 years’ related compliance work experience and/or credentials
• Exceptional communication skills, including presentation capabilities, interpersonal skills and conflict resolution.
• Excellent negotiation skills with exceptional interpersonal communication and oral and written communication skills.
• Ability to maintain an independent and objective perspective.
• BA/BS and/or CHC (Certified in Healthcare Compliance)

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.

Pay Range: $77,969 - $116,835 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.