LTSS Audit Lead: Member Safety & Risk

Molina Healthcare; Wauwatosa (WI); On-site; USD 73,000 - 143,000; Full time

Job summary

Molina Healthcare in the United States seeks a senior leader to manage LTSS audits and risk assessment activities. The role focuses on member health and safety, proactive risk identification, and actionable improvements that enhance quality and cost-effectiveness of care.

The incumbent will oversee audit teams, develop reporting, and present findings to executives, driving corrective actions across departments.

Qualifications

• 7+ years of healthcare experience including care/ utilization management.
• 1+ year of healthcare management/leadership.
• Active clinical licensure if required by state contract/regulation.
• Experience with risk-based audit, monitoring, or quality review programs.
• Ability to analyze data from multiple sources and communicate findings.
• Strong organizational and time-management skills.

Responsibilities

• Oversees LTSS audits related to member health and safety.
• Establishes risk-focused audit programs and schedules.
• Defines priorities, sampling, measures, and escalation criteria.
• Directs audits and ensures proper follow-up and action tracking.
• Aggregates findings across units to identify cross-cutting risks.
• Develops reporting dashboards, trend analyses, and action status reports.
• Presents risk findings to leaders and supports corrective actions.

Skills

Healthcare experience

Leadership

Analytics

Communication

Confidentiality

Time management

Education

Nursing license

Healthcare degree

Tools

Microsoft Office

Job description

Molina Healthcare in the United States seeks a senior leader to manage LTSS audits and risk assessment activities. The role focuses on member health and safety, proactive risk identification, and actionable improvements that enhance quality and cost-effectiveness of care.

The incumbent will oversee audit teams, develop reporting, and present findings to executives, driving corrective actions across departments.