Reporting Analyst, SIU-(Remote)

Lensa; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking a Reporting Analyst for the Special Investigation Unit at Molina Healthcare. This role involves ensuring compliance with regulatory requirements, creating reports, and supporting audits. Ideal candidates will have healthcare experience and proficiency in Excel. Join a dynamic team to enhance operational oversight and compliance.

Qualifications

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

Responsibilities

• Creating regulatory reports related to SIU activities.
• Performing oversight audits and validation activities.
• Ensuring all regulatory reporting requirements are met.

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 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 needed. Ensures timely and accurate gathering and reporting of information, oversees SIU tracking systems, and performs peer reviews to ensure compliance and accuracy. Coordinates with other departments to mitigate and address FWA issues.

Job Duties

1. Creating regulatory reports related to SIU activities, including overpayments, tips/leads, investigations, and summaries.
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, and internal policies.
4. Supporting SIU management in developing the Operational Oversight Program, including reporting, complaint triage, and regulatory compliance demonstrations.
5. Managing and producing regulatory reports inventory.
6. Supporting external audits by preparing documentation, risk assessments, and evidence for audits such as DMHC and CMS.
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 issues.
10. Creating and executing reports to ensure compliance across Molina Health Plans.
11. Serving as a backup to the Senior Reporting Analyst.
12. Performing peer reviews to ensure timely, accurate, and compliant reporting activities.
13. Possessing healthcare experience and proficiency 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 regulatory reporting experience.
• 2-4 years working in managed care organizations.
• 3-5 years in healthcare, especially in Regulatory, Compliance, or Auditing.

Physical Demands

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

Current Molina employees should apply through the intranet. Molina offers competitive benefits. EOE M/F/D/V.

Pay Range: $21.82 - $51.06/hour. Compensation varies by 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