Director, Medicare Compliance - Military veterans preferred

2025-07-11
Molina Healthcare (https://careers.molinahealthcare.com/)
Other

/yr

  full-time   employee


Miami
Florida
United States

Job Description
Job Summary
Provides leadership and organization in the Compliance, Regulatory and Government Relations functional areas for Molina Medicare. Serves as Molina Medicare's liaison to federal regulatory and plan management staff. The Director is responsible for regulatory filings related to Molina Medicare (existing and new). The Director is responsible for implementation and maintenance of third-party contractual relationships entered into in support of Molina Medicare. The Director is responsible for disseminating communications and acts as interdepartmental liaison regarding regulatory and legislative activity relative to Molina Medicare. The Director is co-chairman of the Molina Medicare Compliance Committee. The Director, working with the MHI VP Compliance, is accountable to the Molina Medicare Compliance Committee for all Medicare compliance related activities including but not limited to the development, implementation and maintenance of the Molina Medicare Compliance Plan and audit activities. The Director is responsible for supporting and interfacing with the Molina Government Relations staff on issues and initiatives related to Medicare. The Director is responsible for the direct supervision of Program Integrity Specialist, Molina Medicare, direct supervision of the Manger Appeals and Grievances, Molina Medicare and for providing direction to the Director Auditing, Molina Medicare in a matrix relationship.
  Knowledge/Skills/Abilities
• Provides leadership and organization in the Compliance, Regulatory and Government Relations functional areas for Molina Medicare.
• Serves as Molina Medicare's liaison to federal (CMS) regulatory and plan management staff.
• Responsible for regulatory filings related to Molina Medicare (existing and new).
• Responsible for implementation and maintenance of third-party contractual relationships entered into in support of Molina Medicare.
• Responsible for disseminating widespread communications and acts as interdepartmental liaison regarding regulatory and legislative activity relative to Molina Medicare.
• Co-chairman of the Molina Medicare Compliance Committee.
• Accountable to the Molina Medicare Compliance Committee for all Medicare compliance related activities including but not limited to the development, implementation and maintenance of the Molina Medicare Compliance Plan.
• Responsible for supporting and interfacing with the Molina Government Relations staff on issues and initiatives related to Medicare.
• Responsible for the direct supervision of Program Integrity Specialist, Molina Medicare and for matrix super vision of Director Auditing, Molina Medicare..

Required Experience
Bachelor's in business disciplines and/or equivalent combination of relevant education and experience.
Preferred Education
JD and/or MBA preferred

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: $101,721 - $206,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.