Remote Health Plan Regulatory Analyst & Requirements Lead

Molina Healthcare, Inc.; United States; Remote; USD 70,000 - 95,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a qualified professional to manage intake and interpretation of regulatory and program requirements, supporting systems solutions development and governance processes.

You will coordinate with stakeholders and subject matter experts across partnering teams to ensure alignment and timely delivery. You will develop requirement documents for coverage and reimbursement, monitor updates, and communicate interpretations to health plans and product teams.

Qualifications

• At least 2 years of experience in managed care or health insurance.
• Strong analytical and problem-solving skills.
• Proficient with Office Suite including Word, Excel, Outlook and Teams.
• Ability to work autonomously in a remote environment.

Responsibilities

• Develops and maintains requirement documents for coverage, reimbursement and system changes.
• Monitors sources to ensure updates are aligned with regulatory baselines.
• Leads development and management of interpretation reviews with partner organizations.
• Conducts root cause analysis and supports problem management.
• Communicates interpretations and changes to health plans and product teams.
• Self-organized reporting to inform leadership of impact on financials.
• Engages with operations leadership to review compliance-based issues for benefits planning.
• Builds VILT sessions in the Learning Management System (LMS).
• Supports intake triage, scheduling logistics, and report reconciliation.
• Identifies and applies automation and AI tools to improve processes.

Skills

Relationship building

Excellent communication

Requirements synthesis

Remote work

Time management

Regulatory knowledge

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft Teams

Job description

Molina Healthcare, Inc. is seeking a qualified professional to manage intake and interpretation of regulatory and program requirements, supporting systems solutions development and governance processes.

You will coordinate with stakeholders and subject matter experts across partnering teams to ensure alignment and timely delivery. You will develop requirement documents for coverage and reimbursement, monitor updates, and communicate interpretations to health plans and product teams.