Medicare Compliance Manager (Medicare Advantage Required) - REMOTE

Molina Healthcare; Phoenix (AZ); Remote; USD 77,000 - 156,000; Full time

Job summary

A healthcare organization in Phoenix is seeking a Compliance Manager to establish a compliance program that prevents violations of laws and regulations. The role involves overseeing compliance operations, coordinating audits, and ensuring the organization’s accountability. Ideal candidates will have 5-7 years of relevant experience and a Bachelor's degree, with a Master's preferred. This position offers a competitive salary ranging from $77,969 to $155,508 annually.

Benefits

Competitive benefits and compensation package

Qualifications

• 5-7 years of relevant experience in compliance or regulatory settings.
• Experience in health plan settings is preferred.
• Ability to manage complex compliance issues.

Responsibilities

• Establish a compliance program to prevent violations of laws.
• Implement and oversee compliance policies and procedures.
• Coordinate corrective actions for compliance audits.

Skills

Implementation of Compliance Programs

Development of compliance policies

Overseeing regulatory audits

Investigating compliance issues

Staying updated on industry trends

Education

Bachelor's Degree

Master's Degree (preferred)

Job description

Job Description

Job Summary

Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations.

Knowledge/Skills/Abilities

• Assists with implementation and day-to-day operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the enterprise while ensuring compliance with governmental requirements.

• Spearheads development and implementation of compliance policies and procedures and training programs for the Molina enterprise.

• Oversees and provides direction of site visits for regulatory audits and coordinates corrective action plan, as needed.

• Investigates and resolves compliance problems, questions, or complaints received internally or from customers/agencies.

• Provides input and representation on key compliance initiatives, meetings, and committees. Stays abreast of industry and compliance trends; recommends and implements changes to internal company processes as needed..

Job Qualifications

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-7 years

Preferred Education

Masters Degree preferred; will consider previous experience in health plan setting in government programs management (Contract Manager)

Preferred Experience

7-9 years

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 - $155,508 / ANNUAL

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