Reporting Analyst, SIU-(Remote)

Lensa; Tampa (FL); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare company is seeking a Reporting Analyst for their Special Investigation Unit (SIU). The role involves creating regulatory reports, ensuring compliance with laws, and supporting audit procedures. Ideal candidates will have an Associate Degree and experience in healthcare or regulatory fields, with proficiency in Excel.

Qualifications

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

Responsibilities

• Create regulatory reports specific to the SIU.
• Interpret and analyze state and federal regulatory rules.
• Perform oversight audits and validation activities.

Skills

Healthcare experience

Proficient in Excel

Regulatory compliance

Education

Associate Degree

Job description

2 days ago Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

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/or law enforcement as appropriate. They will ensure that information is gathered and reported timely and accurately, and oversee designated SIU tracking systems. Duties may include peer reviews to ensure timely, accurate reporting and compliance, and coordination with other departments to mitigate and remedy FWA.

Job Duties

1. Responsible for creating regulatory reports specific to the SIU, including reports on overpayments identified and recovered, tips/leads received, investigative case activity, and other summary reports.
2. Interpret and analyze state and federal 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, contract provisions, and internal policies.
4. Support the SIU Manager, Director, and team in developing the Operational Oversight Program, including report creation, complaint intake triage, and demonstrating compliance across Molina Healthcare Plans.
5. Manage and produce a personal inventory of regulatory reports.
6. Support health plans and MHI Business Owners with external regulatory audits, including risk assessments, sample submissions, and documentation.
7. Develop and communicate audit scope, objectives, and timelines in collaboration with stakeholders.
8. Develop trend reports to ensure compliance and identify training needs.
9. Ensure all regulatory reporting requirements for FWA are met to avoid non-compliance issues.
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 to ensure reporting activities are timely, accurate, and compliant.
13. Possess healthcare experience and be proficient in Excel; Healthcare Fraud Shield experience is preferred.

Job Qualifications

Required Education

Associate Degree or equivalent combination of education and experience.

Required Experience/Skills

Minimum 2 years experience in SIU, law enforcement, healthcare, or regulatory fields.

Preferred Experience

• 1+ years’ experience with regulatory reporting.
• 2-4 years working for a managed care organization.
• 3-5 years in healthcare industry in related fields (Regulatory, Compliance, Auditing).

Physical Demands

Work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations available for disabilities.

Interested Molina employees should apply through the intranet. Molina offers competitive benefits and is an EOE M/F/D/V.

Pay Range: $21.82 - $51.06/hourly. Actual pay may vary 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