Analyst, Compliance

Posted Yesterday
2 Locations
In-Office or Remote
Junior
Insurance
The Role
Support compliance operations by managing Corrective Action Plans (CAPs) from initiation to remediation, analyze root causes and regulatory requirements, coordinate with business areas and regulators, maintain KPI and compliance reporting, interpret federal/state regulations, and manage compliance systems and CMS access.
Summary Generated by Built In

JOB DESCRIPTION Job Summary

Provides analyst support for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevent and/or detect violation of applicable laws and regulations, and protect the business from liability, fraudulent or abusive practices.

Reporting to the Compliance Manager of CAP Oversight, the CAP Analyst is responsible for the development and administration of Corrective Action Plans (CAP) and leading efforts to ensure that the required actions are implemented and effective at remediating the issue(s) of non-compliance
 

Essential Job Duties

  • Manage each Corrective action as assigned.
  • Supports day‑to‑day compliance operations, including managing compliance incidents and assigned corrective action plans (CAPs) from initiation through timely, accurate completion.
  • Reviews and analyzes CAP root causes, regulatory requirements, and Medicare/Medicaid/MMP reporting to ensure accuracy and alignment with federal and state guidelines.
  • Coordinates communication and meetings with business areas, compliance officers, regulators, and other stakeholders to support remediation and broader compliance activities.
  • Facilitates required compliance reporting, maintains KPI reports, and supports distribution of regulatory memoranda and related documentation.
  • Interprets and analyzes federal and state regulatory manuals, rules, and proposed rulemaking; assists with revisions and coordinates organizational comments.
  • Leads or supports complex compliance projects, coordinates regulator site visits, and manages compliance systems such as Compliance Central and CMS user access.
     

Job Requirements

• At least 2 years of compliance and/or audit-related experience, or equivalent combination of relevant education and experience. 
• Knowledge of health care regulatory frameworks. 
• Detail-oriented; skilled in documentation review. 
• Data analysis skills, and ability to generate reports. 
• Ability to work independently and set/manage priorities. 
• Ability to collaborate in a cross-functional highly matrixed organization, and interact with internal/external stakeholders, including regulators. 
• Effective verbal and written communication skills. 
• Microsoft Office suite and applicable software program(s) proficiency.
 

Preferred Qualifications

• Certified in Healthcare Compliance (CHC). 
• Experience with risk assessment methodologies. 
• Knowledge of internal control frameworks.


To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Skills Required

  • At least 2 years of compliance and/or audit-related experience
  • Knowledge of health care regulatory frameworks
  • Detail-oriented with strong documentation review skills
  • Data analysis skills and ability to generate reports
  • Ability to work independently and set/manage priorities
  • Ability to collaborate in a cross-functional, matrixed organization and interact with regulators and stakeholders
  • Effective verbal and written communication skills
  • Proficiency with Microsoft Office and applicable software programs
  • Certified in Healthcare Compliance (CHC)
  • Experience with risk assessment methodologies
  • Knowledge of internal control frameworks
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The Company

What We Do

Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.

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