Reporting Analyst, SIU-(Remote)

Lensa; Omaha (NE); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking a Reporting Analyst for Molina Healthcare in Omaha, NE. The role involves ensuring compliance with regulatory reporting requirements and supporting the Special Investigation Unit. Candidates should have experience in SIU or healthcare compliance and proficiency in Excel.

Qualifications

• Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.
• Preferred 1+ years in regulatory reporting.

Responsibilities

• Create regulatory reports supporting contractual requirements.
• Perform oversight audits and validation activities.
• Ensure compliance with all Molina Health Plans.

Skills

Excel

Healthcare Fraud Knowledge

Education

Associate Degree

Job description

Job Description

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Summary

Under the 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 law enforcement as needed. They ensure timely and accurate data collection and reporting, oversee SIU tracking systems, and perform peer reviews to ensure compliance and accuracy.

Job Duties

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

Qualifications

Education: Associate Degree or equivalent experience.

Experience: Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields. Preferred 1+ years in regulatory reporting. Experience in managed care and healthcare compliance is desirable.

Physical Demands

Office environment, sitting for long periods, with accommodations available for disabilities.

Additional Information

Position is mid-senior level, contract employment, based in Omaha, NE. Salary range: $21.82 - $51.06/hour. Benefits and equal opportunity employer.