Compliance Manager

Molina Healthcare • Long Beach, CA

4h

About The Position

Provides subject matter expertise and leadership for compliance activities.
Seeks to ensure the organization adheres to regulatory requirements, industry
standards, and Molina internal policies, and prevents and/or detects violation
of applicable laws and regulations, and protect the business from liability,
fraudulent or abusive practices. Essential Job Duties
• Key contributor in ensuring that the business understands and complies with
applicable laws and regulations pertaining to the health care environment, and
ensures business accountability for compliance by overseeing, following-up and
resolving investigations.
• Assists with implementation and day-to-day operations of the compliance
program, compliance plan, code of conduct, and fraud, waste and abuse (FWA) plan
across the enterprise, and ensuring compliance with governmental requirements.
• Spearheads development and implementation of compliance policies and
procedures, and training programs for the Molina enterprise.
• Oversees and provides direction of site visits for regulatory audits, and
coordinates corrective action plans (CAPs), as necessary.
• Investigates and resolves compliance issues, inquiries, or complaints received
internally or from customers/agencies.
• Provides input and representation on key compliance initiatives, meetings, and
committees.
• Stays abreast of industry and compliance trends, and recommends and implements
changes to internal company processes as needed.

Requirements

• At least 5 years of experience in compliance, risk management, and/or auditing, or equivalent combination of relevant education and experience.
• Strong knowledge of relevant regulatory frameworks and industry standards.
• Experience developing and implementing compliance programs.
• Ability to thrive in a cross-functional highly matrixed environment.
• Strong analytical and problem-solving skills.
• Project management experience.
• Ability to build rapport and gain the respect and collaboration of internal/external stakeholders.
• Knowledge and ability to think creatively, proactively, and independently.
• Ability to prepare reports and presentations, and manage data.
• Self-motivated and results oriented.
• Strong organizational skills and the ability to meet delivery targets.
• Disciplined and ability to effectively track, document and report on projects/activities.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.

Nice To Haves

• Previous experience in a health plan or government programs setting (Medicaid, Medicare, Marketplace).
• Certificate in Healthcare Compliance (CHC), or other compliance-related certification.

Responsibilities

• Ensuring that the business understands and complies with applicable laws and regulations pertaining to the health care environment
• Ensuring business accountability for compliance by overseeing, following-up and resolving investigations
• Assists with implementation and day-to-day operations of the compliance program, compliance plan, code of conduct, and fraud, waste and abuse (FWA) plan across the enterprise, and ensuring compliance with governmental requirements
• Spearheads development and implementation of compliance policies and procedures, and training programs for the Molina enterprise
• Oversees and provides direction of site visits for regulatory audits, and coordinates corrective action plans (CAPs), as necessary
• Investigates and resolves compliance issues, inquiries, or complaints received internally or from customers/agencies
• Provides input and representation on key compliance initiatives, meetings, and committees
• Stays abreast of industry and compliance trends, and recommends and implements changes to internal company processes as needed

Benefits

• Molina Healthcare offers a competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed