Senior Audit Lead & Data Insights

Molina Healthcare; Northern (KY); Hybrid; USD 60,000 - 130,000; Full time

Job summary

Molina Healthcare seeks an experienced audit professional to oversee accuracy of claims databases and configurations across contracts, benefits, and authorizations. You will train staff, interpret complex requirements, and deliver clear audit results.

Responsibilities include leading projects, mentoring junior auditors, and ensuring timely, standards-compliant audits across multiple states using QNXT, AutoQ, and MRDT tools.

Qualifications

• Bachelor’s Degree or equivalent combination of education and experience.
• 5-6 Years of experience required.
• Graduate Degree preferred; 7+ Years preferred.

Responsibilities

• Audit critical information on claims databases accurately and timely.
• Synchronize data among systems and apply business rules as they pertain to each database.
• Validate configuration accuracy per contracting, benefits, prior authorizations, fees, and other requirements.
• Assign workload to auditors and monitor workflow.
• Train and coach new employees and mentor junior staff.
• Provide clear results and comments to leaders about focal and random audits across states.
• Ensure audits are conducted timely and in line with standards.

Skills

Staff training

Requirements analysis

Management reporting

Ad-hoc reporting

Mentoring

Project leadership

Communication of findings

Education

Bachelor’s Degree or equivalent

Graduate degree preferred

Tools

QNXT

AutoQ

MCG

MRDT

Job description

Molina Healthcare seeks an experienced audit professional to oversee accuracy of claims databases and configurations across contracts, benefits, and authorizations. You will train staff, interpret complex requirements, and deliver clear audit results.

Responsibilities include leading projects, mentoring junior auditors, and ensuring timely, standards-compliant audits across multiple states using QNXT, AutoQ, and MRDT tools.