Reporting Analyst, SIU-(Remote)

Lensa; West Valley City (UT); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in healthcare is seeking a Reporting Analyst for their Special Investigation Unit. This role involves ensuring compliance through regulatory reporting, oversight audits, and supporting the SIU team. Ideal candidates will have healthcare experience and proficiency in Excel, with opportunities for growth and competitive benefits.

Qualifications

• Minimum 2 years in SIU, law enforcement, healthcare, or regulatory fields.
• Preferred: 1 year in regulatory reporting; 2-4 years in managed care.

Responsibilities

• Creating regulatory reports related to SIU activities.
• Performing oversight audits and validation activities for compliance.
• Managing and producing regulatory reports.

Skills

Healthcare Experience

Excel

Education

Associate Degree

Job description

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 necessary. They will ensure that information is gathered and reported accurately and timely (monthly, quarterly, annually). The role includes oversight of SIU tracking systems and performing peer reviews to ensure compliance and accuracy.

Job Duties

1. Creating regulatory reports related to SIU, including overpayments, tips/leads, investigative activities, and summaries.
2. Interpreting and analyzing regulatory rules, contracts, and guidance to support compliance and audit procedures.
3. Performing oversight audits and validation activities to ensure compliance with laws, regulations, and policies.
4. Supporting the SIU Manager and team in developing the Operational Oversight Program, including report creation and complaint management.
5. Managing and producing regulatory reports.
6. Supporting external regulatory audits, including risk assessments and document submissions.
7. Developing and communicating audit scope, objectives, and timelines in collaboration with stakeholders.
8. Developing trend reports for compliance and performance improvement.
9. Ensuring all regulatory reporting requirements are met to avoid non-compliance issues.
10. Ensuring compliance with Molina Health Plans through report creation and execution.
11. Serving as a backup to the Senior Reporting Analyst.
12. Performing peer reviews to ensure reporting accuracy and timeliness.
13. Possessing 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 compliance or auditing.

Physical Demands

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

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay range: $21.82 - $51.06/hour, varies by location and experience.