Reporting Analyst, SIU-(Remote)

Lensa; Layton (UT); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking a Reporting Analyst for Molina Healthcare's Special Investigation Unit. The role involves ensuring FWA referrals are documented and reported, creating regulatory reports, and supporting compliance efforts. Ideal candidates have healthcare experience and strong analytical skills.

Qualifications

• Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.
• 1+ years in regulatory reporting; 2-4 years in managed care; 3-5 years in healthcare regulatory.

Responsibilities

• Create regulatory reports specific to the SIU.
• Perform oversight audits to ensure compliance with laws.
• Analyze trend reports to ensure compliance.

Skills

Healthcare Fraud Shield

Excel

Compliance

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 ensures FWA referrals are logged, documented, assigned for investigation, and appropriately reported to state and federal regulators and/or law enforcement as needed. They ensure that information is gathered and reported accurately and timely (monthly, quarterly, annually). They oversee designated SIU tracking systems. Duties include peer reviews to ensure timely, accurate reporting and compliance, as well as coordination with other departments to mitigate and address FWA issues.

Job Duties

1. Create regulatory reports specific to the SIU, including reports on overpayments, tips/leads, investigative activities, and summaries.
2. Interpret and analyze state and federal 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 internal policies.
4. Support the SIU Manager, Director, and team in developing the Operational Oversight Program, including creating reports, triaging FWA complaints, and ensuring regulatory compliance.
5. Manage and produce a personal inventory of regulatory reports.
6. Assist health plans and MHI Business Owners with external regulatory audits, including risk assessments and documentation submissions.
7. Develop and communicate audit scope, objectives, and timelines in collaboration with stakeholders.
8. Analyze trend reports to ensure compliance and identify training needs.
9. Ensure MHI meets all regulatory reporting requirements for FWA notifications.
10. Maintain compliance with all Molina Health Plans through report creation and execution.
11. Serve as backup to the Senior Reporting Analyst.
12. Perform peer reviews for reporting activities to ensure accuracy and compliance.
13. Apply healthcare experience and Excel proficiency; healthcare fraud shield experience is preferred.

Job Qualifications

Required Education: Associate Degree or equivalent experience.

Experience/Skills: Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.

Preferred Experience: 1+ years in regulatory reporting; 2-4 years in managed care; 3-5 years in healthcare regulatory, compliance, or auditing.

Physical Demands

Work is in an office environment with adequate lighting and temperature. Must be able to sit for long periods. Accommodations available for disabilities.

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

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

Additional Details

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

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