Analyst, Compliance - Remote must have Medicare Advantage exp
Job Summary
(Sales) Compliance Analyst
Molina Healthcare's Medicare Compliance team provides oversight for sales operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities.
Knowledge/Skills/Abilities
- Provide regulatory expertise to the Sales Organization: both State and Federal
- Have working knowledge of federal and state guidelines pertaining to Sales and Marketing
- Perform internal Sales/Marketing Compliance Reporting
- Perform internal Sales/Marketing monitoring
- Detailed oriented to conduct thorough Sales allegations investigations
- Recommend applicable corrective action(s) when applicable to business partners
- Process improvement driven
- Create, update, and retire P&Ps, Standard Operating Procedures and Training documents
- Lead regularly scheduled Sales & Compliance leadership meetings
- Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications
- Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports
- Review and interpret internal Sales dashboards for outliers and deeper dive research
- Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found
- Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.)
- Leads projects to achieve Sales compliance objectives
- Interpret and analyze state and federal regulatory manuals and revisions
- Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight
- Interact with Molina external customers, via verbal and written communication
- Ability to work independently, and set priorities
Experience
- 2+ years related compliance work experience
- Exceptional communication skills, including presentation capabilities, both written and verbal
- Excellent interpersonal communication and oral and written communication skills
- High level Interaction with Leadership
- Sales Allegation Investigations
- Policies & Procedures
Preferred Qualifications
- Certified in Healthcare Compliance (CHC)
- Experience with risk assessment methodologies
- Knowledge of internal control frameworks
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range
$40,851.44 - $88,511.46 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.