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