Reporting Analyst, SIU-(Remote)

Lensa; Ann Arbor (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Reporting Analyst for the Special Investigation Unit (SIU). The role involves creating regulatory reports, ensuring compliance with laws, and supporting audits. Ideal candidates will have healthcare experience and proficiency in Excel. This position offers competitive pay and the opportunity to work in a supportive environment.

Qualifications

• Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.
• Minimum 1 year with regulatory reporting; 2-4 years in managed care.

Responsibilities

• Create regulatory reports specific to the SIU.
• Perform oversight audits and validation activities.
• Manage and produce regulatory reports independently.

Skills

Healthcare Experience

Proficiency in Excel

Education

Associate Degree

Job description

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Job Description

Job Summary

Under the direct supervision of the Manager, the Reporting Analyst, SIU supports a team in the Special Investigation Unit (SIU). The Reporting Analyst, SIU will ensure FWA referrals are logged, documented, assigned for investigation, and appropriately reported to state and federal regulators and law enforcement as appropriate. They will ensure that the necessary information is gathered and reported in a timely and accurate manner (monthly, quarterly, annually). The role also involves overseeing designated SIU tracking systems and performing peer reviews to ensure compliance and accuracy.

Job Duties

1. Create regulatory reports specific to the SIU, including overpayment recoveries, tips/leads, investigative activities, and other summaries.
2. Interpret and analyze regulations, contracts, and guidance to assess compliance and support audit procedures.
3. Perform oversight audits and validation activities to ensure compliance with laws, regulations, and policies.
4. Support the SIU Manager and team in developing the Operational Oversight Program, including reporting, complaint triage, and regulatory compliance.
5. Manage and produce regulatory reports independently.
6. Assist with external regulatory audits, including risk assessments and document submissions.
7. Develop and communicate audit scope, objectives, and timelines in collaboration with stakeholders.
8. Develop trend reports for performance and compliance monitoring and identify training needs.
9. Ensure all regulatory reporting requirements are met to prevent non-compliance.
10. Maintain compliance with Molina Health Plans through report creation and execution.
11. Serve as a backup to the Senior Reporting Analyst.
12. Perform peer reviews for reporting activities to ensure timeliness and accuracy.
13. Possess healthcare experience and proficiency in Excel; healthcare fraud experience is preferred.

Job Qualifications

Required Education

Associate Degree or equivalent combination of education and experience.

Required Experience/Skills

Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.

Preferred Experience

Minimum 1 year with regulatory reporting; 2-4 years in managed care; 3-5 years in healthcare regulatory, compliance, or auditing.

Physical Demands

Work is primarily in an office environment with minimal hazards. Must be able to sit for long periods. Accommodations available for disabilities.

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.82 - $51.06/hour. Actual pay varies by location, experience, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Contract
• Job function: Research, Analyst, IT
• Industries: IT Services and Consulting