Compliance Analyst (TX Health Plan) - REMOTE Central Time - Military veterans preferred

2025-07-16
Molina Healthcare (https://careers.molinahealthcare.com/)
Other

/yr

  full-time   employee


Lincoln
Nebraska
United States

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. This position is supporting compliance operations for Molina's Texas Health Plan.

KNOWLEDGE/SKILLS/ABILITIES

The Compliance Analyst position is primarily responsibility for supporting the day to day operations and initiatives of the Texas Compliance function.

  • Provides technical expertise to regulatory & legislative interpretation inquiries.
  • Performs Plan Required Reporting as needed
  • Interpret and analyze Medicare, Medicaid and MMP Required Reporting Specifications.
  • Create and maintain monthly and quarterly Key Performance Indicator (KPI) reports.
  • Manages compliance incidents management and related processes, including associated corrective action plans.
  • Provides technical expertise with Molina interdepartmental regulatory & legislative interpretation inquiries.
  • Responds to legislative inquiries/complaints (state insurance regulators, Congressional, etc.).
  • Assists with the regulatory memo distribution process.
  • Leads large, complex projects to achieve compliance objectives.
  • Interprets and analyzes state and federal regulatory manuals and revisions.
  • Interprets and analyzes federal and state rules and requirements for proposed & final rules.
  • Ensure completion and delivery of audit deliverables, including tracking, reporting and review of audit items to meet regulatory requests.
  • Enter, track, manage and report on Corrective Action Plans, both internal and regulatory.
  • Ability to work independently and set priorities.

JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS: 

  • 3-4 years’ related compliance work experience and/or credentials 
  • Exceptional communication skills, including presentation capabilities, interpersonal skills and conflict resolution. 
  • Excellent negotiation skills with exceptional interpersonal communication and oral and written communication skills.   
  • Ability to maintain an independent and objective perspective. 

PREFERRED QUALIFICATIONS:   

  • BA/BS and/or CHC (Certified in Healthcare Compliance)

 

 

 

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: $77,969 - $95,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.