Health Plan Regulatory Analyst

Molina Healthcare; United States; Remote; USD 45,000 - 97,000; Full time

Job summary

Molina Healthcare is seeking a Regulatory/Requirements Analyst to support intake and interpretation of regulatory and functional requirements for coverage, reimbursement, and processing systems. You will coordinate with stakeholders and partner teams, supporting governance committees as applicable.

The role emphasizes documentation, testing, and cross-functional communication to ensure alignment with regulatory baselines and health plan requirements, while enabling timely and accurate system

Qualifications

• At least 2 years of experience in managed care, health insurance or related field.
• Policy/government legislative review knowledge.
• Strong analytical and problem-solving skills.
• Robust knowledge of Office product suite including Word, Excel, Outlook and Teams.
• Previous success in a dynamic and autonomous work environment.

Responsibilities

• Develops and maintains requirement documents for coverage, reimbursement and system changes.
• Facilitates user acceptance testing (UAT) including creating scenarios and tracking defects.
• Monitors sources to ensure updates align with regulatory baseline.
• Leads development and management/interpretation review with partner organizations.
• Conducts analysis to identify root causes and supports problem management for state requirements.
• Communicates interpretations and changes to health plans and product teams for alignment and traceability.
• Supports interpretation inconsistencies and complaints.
• Self-organized reporting to keep leadership informed on work efforts and impact of changes.
• Engages with operations and Plan Support to review compliance-based issues for benefit planning.

Skills

Regulatory knowledge

Requirement analysis

Stakeholder communication

UAT coordination

Tools

Jira

Office 365

Teams

Job description

Molina Healthcare is seeking a Regulatory/Requirements Analyst to support intake and interpretation of regulatory and functional requirements for coverage, reimbursement, and processing systems. You will coordinate with stakeholders and partner teams, supporting governance committees as applicable.

The role emphasizes documentation, testing, and cross-functional communication to ensure alignment with regulatory baselines and health plan requirements, while enabling timely and accurate system