Compliance Analyst (REMOTE - NY ONLY - Travel Required)
: Job Details :


Compliance Analyst (REMOTE - NY ONLY - Travel Required)

Molina Healthcare

Location: New York,NY, USA

Date: 2025-01-01T07:04:18Z

Job Description:

**JOB DESCRIPTION**

**Job Summary**

Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a centralized corporate function supporting compliance activities at individual state health plans. The Compliance Analyst position is a field based auditor position with up to 90% required travel within the New York Metropolitan area.

**KNOWLEDGE/SKILLS/ABILITIES**

The Compliance Analyst position is primarily responsible for supporting the day to day operations and initiatives of the Compliance Department.

+ Performs Plan Required Reporting.

+ Interpret and analyzes Medicare, Medicaid and Medicare Medicaid Plan Required Reporting Technical Specifications.

+ Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.

+ Support management with New York State Assistor Concerns (Tracking/Action/Reporting)

+ Conduct secret shop visits of Molina's Sales team and sites to determine compliance with applicable rules and regulations and assess customer service.

+ Assess Facilitated Enrollers, Managed Long Term Care and Medicaid Advantage Plus Representatives' product knowledge.

+ Document and submit detailed reports about the visits, including time, date, and staff interactions.

+ Conduct telephonic audits of Molina's Facilitated Enrollers.

+ Conduct enrollment application audits.

+ Ability to work independently and set priorities

+ Excellent communication, observation and written skills.

+ Strong analytical and reporting skills

+ Must have a valid driver's license and reliable transportation.

**JOB QUALIFICATIONS**

**Required Education**

BA/BS/BC degree Healthcare Administration or minimum equivalent employment experience of 4+ years, Health Care or related field required

**Required Experience**

4 years' experience in health care industry in related field desired

**Preferred Education**

BA/BS/BC Healthcare Administration

**Preferred Experience**

4 years' experience in health care industry in related field desired

**Preferred License, Certification, Association**

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $62,400 - $106,214 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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