Reporting Analyst, SIU-(Remote)

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

Job summary

An established industry player is seeking a Reporting Analyst to join their Special Investigation Unit. This role is crucial in ensuring compliance with state and federal regulations while managing and producing regulatory reports. The ideal candidate will have a strong background in healthcare, compliance, and auditing, with proficiency in Excel and regulatory reporting. This position offers the opportunity to contribute to significant operational oversight programs and ensure accurate reporting of fraud, waste, and abuse activities. If you're passionate about compliance and have a keen eye for detail, this role is perfect for you.

Qualifications

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

Responsibilities

• Create and manage regulatory reports for the Special Investigation Unit.
• Conduct audits to ensure compliance with laws and regulations.
• Support the SIU Manager in developing operational oversight programs.

Skills

Regulatory Reporting

Compliance Auditing

Data Analysis

Excel Proficiency

Healthcare Knowledge

Education

Associate Degree

Tools

Healthcare Fraud Shield

Job description

1 day ago Be among the first 25 applicants

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 will ensure FWA referrals are logged, documented, assigned for investigation, and appropriately reported to state and federal regulators and/or law enforcement as needed. They ensure timely and accurate gathering and reporting of information, oversee designated SIU tracking systems, and may perform peer reviews to ensure compliance and accuracy in reporting activities.

Job Duties

• Create regulatory reports specific to the SIU, including overpayments, tips/leads, investigative activities, and other summaries.
• Interpret and analyze regulatory rules, contracts, and guidance to assess compliance and support audit procedures.
• Perform oversight audits and validation activities to ensure compliance with laws, regulations, and policies.
• Support the SIU Manager and team in developing the Operational Oversight Program, including report creation, complaint triage, and regulatory compliance demonstration.
• Manage and produce regulatory reports inventory.
• Assist with external regulatory audits, including risk assessments and submission of requested documentation.
• Develop and communicate audit scope, objectives, and timelines with stakeholders.
• Develop trend reports for compliance and performance improvement, and identify training needs.
• Ensure all regulatory reporting requirements for FWA notifications are met to avoid non-compliance.
• Ensure compliance with all Molina Health Plans through report creation and execution.
• Serve as a backup to the Senior Reporting Analyst.
• Perform peer reviews to ensure timely, accurate, and compliant reporting activities.
• 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.

Preferred Experience: Minimum 1 year in regulatory reporting; 2-4 years in managed care; 3-5 years in healthcare regulatory, compliance, or auditing.

Physical Demands

Work is performed in an office environment with minimal hazards. Must be able to sit for long periods. Accommodations available for disabilities.

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. We are an 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, Analyst, IT
• Industries: IT Services and Consulting