Reporting Analyst, SIU-(Remote)

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

Job summary

A leading career site is seeking a Reporting Analyst for the Special Investigation Unit (SIU). This remote role involves managing regulatory reports, ensuring compliance with laws, and supporting audits. Ideal candidates will have healthcare experience and strong Excel skills.

Qualifications

• Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.
• 1+ years in regulatory reporting preferred.
• 2-4 years working for a managed care organization preferred.

Responsibilities

• Creating regulatory reports specific to the SIU.
• Performing oversight audits and validation activities for compliance.
• Supporting external regulatory audits and document submissions.

Skills

Healthcare experience

Excel proficiency

Education

Associate Degree or equivalent

Job description

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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 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 appropriate. They ensure that information is gathered and reported accurately and timely (monthly, quarterly, annually). They oversee designated SIU tracking systems. Duties include performing peer reviews to ensure timely, accurate, and compliant reporting activities, and coordinating with other departments to mitigate and address FWA issues.

Job Duties (Main Responsibilities)

1. Creating regulatory reports specific to the SIU, including overpayments, tips/leads, investigative activity, and summary reports.
2. Interpreting and analyzing regulatory rules, contracts, and guidance to assess compliance and support audit procedures.
3. Performing oversight audits and validation activities to ensure compliance with laws, regulations, contracts, and policies.
4. Supporting the SIU Manager and team in developing the Operational Oversight Program, including report creation, complaint triage, and regulatory compliance demonstration.
5. Managing and producing regulatory reports.
6. Supporting external regulatory audits, including risk assessments and document submissions.
7. Developing and communicating audit scope, objectives, and timelines with stakeholders.
8. Developing trend reports for compliance and performance improvement, and identifying training needs.
9. Ensuring all regulatory reporting requirements are met to prevent non-compliance.
10. Ensuring compliance with all Molina Health Plans through report creation and execution.
11. Serving as a backup to the Senior Reporting Analyst.
12. Performing peer reviews for reporting activities.
13. Healthcare experience and Excel proficiency are required; Healthcare Fraud Shield 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

• 1+ years in regulatory reporting.
• 2-4 years working for a managed care organization.
• 3-5 years in healthcare industry related to Regulatory, Compliance, and Auditing.

Physical Demands

Office environment, minimal hazards, ability to sit for long periods. Accommodations available for disabilities.

Interested Molina employees should apply via the intranet.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

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

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Contract
• Job functions: Research, Analysis, IT
• Industries: Healthcare, Non-profit, Government

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