Reporting Analyst, SIU-(Remote)

Lensa; Salt Lake City (UT); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Reporting Analyst for the Special Investigation Unit in Salt Lake City. The role involves ensuring compliance with regulations, creating reports, and supporting audits. Candidates should possess healthcare experience and proficiency in Excel. This is a contract position with competitive hourly pay.

Qualifications

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

Responsibilities

• Create regulatory reports specific to the SIU.
• Perform oversight audits and validation activities.
• Support the SIU Manager in developing the Operational Oversight Program.

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 timely and accurate information is gathered and reported on a regular basis. The role also involves oversight of 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

1. Create regulatory reports specific to the SIU, including reports on overpayments recovered, tips/leads received, investigative activities, and other 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, contracts, and internal policies.
4. Support the SIU Manager, Director, and team in developing the Operational Oversight Program, including creating reports, triaging FWA complaints, assigning cases, and ensuring regulatory compliance across Molina Healthcare Plans.
5. Manage and produce a personal inventory of regulatory reports.
6. Assist with external regulatory audits, including risk assessments, preparing sample data, and submitting documentation such as SOPs and training materials (e.g., DMHC, CMS audits).
7. Develop and communicate audit scope, objectives, and timelines in collaboration with stakeholders.
8. Develop trend reports to monitor compliance and performance, and identify training needs.
9. Ensure all regulatory reporting requirements for FWA notifications are met to prevent non-compliance.
10. Create and execute reports to ensure compliance across Molina Health Plans.
11. Serve as a backup to the Senior Reporting Analyst.
12. Perform peer reviews to ensure reporting accuracy and timeliness.
13. Possess healthcare experience and proficiency in Excel.
14. Healthcare Fraud Shield certification is preferred.

Job Qualifications

Required Education

Associate Degree or equivalent 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 regulatory, compliance, or auditing roles.

Physical Demands

Work is generally performed in an office setting with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations are available for individuals with disabilities.

Interested Molina employees should apply through 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

• Compensation varies based on location, experience, education, and skills.

Additional Details

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

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