Reporting Analyst, SIU-(Remote)

Lensa; Tampa (FL); Remote; Full time

Job summary

A leading career site is seeking a Reporting Analyst for the Special Investigation Unit (SIU) at Molina Healthcare. This role involves ensuring compliance with FWA regulations, creating reports, and supporting audits. Ideal candidates will have healthcare experience and proficiency in Excel.

Benefits

Competitive benefits

Qualifications

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

Responsibilities

• Create regulatory reports specific to the SIU, including overpayments and case activity.
• Perform oversight audits to ensure compliance with laws and regulations.
• Support external regulatory audits by preparing risk assessments.

Skills

Healthcare experience

Proficiency in Excel

Education

Associate Degree

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, 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 (monthly, quarterly, annually). They will oversee designated SIU tracking systems. Duties include peer reviews to ensure timely, accurate, and compliant reporting activities and coordination with other departments to mitigate and remedy FWA.

Job Duties

1. Create regulatory reports specific to the SIU, including overpayments, 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 team in developing the Operational Oversight Program, creating reports, triaging FWA complaints, and demonstrating regulatory compliance.
5. Manage and produce a personal inventory of regulatory reports.
6. Support external regulatory audits by preparing risk assessments, sample universes, SOPs, and other documentation.
7. Develop and communicate audit scope, objectives, and timelines in collaboration with stakeholders.
8. Develop trend reports for compliance, performance, and training needs.
9. Ensure all regulatory reporting requirements for FWA 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. Possess healthcare experience and proficiency in Excel; Healthcare Fraud Shield experience 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. Experience with regulatory reporting is preferred. Additional experience in managed care, healthcare industry, compliance, or auditing is desirable.

Physical Demands

Office environment, sitting for long periods, minimal exposure to hazards. Accommodations available for disabilities.

Interested current 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/hourly

Additional Information

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