Molina Healthcare-posted 9 months ago
$80,412 - $188,164/Yr
Full-time • Senior
Insurance Carriers and Related Activities

Provides leadership and expertise to help facilitate compliance with applicable statutes, contractual requirements, policies and procedures to ensure enterprise compliance. Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations.

  • Assists with implementation and day-to-day operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the enterprise while ensuring compliance with governmental requirements.
  • Manages the day-to-day activities, including management and oversight of Compliance Analysts.
  • Develops a team focused on meeting and exceeding established performance targets.
  • 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 plan, as needed.
  • Investigates and resolves compliance problems, questions, 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; recommends and implements changes to internal company processes as needed.
  • Bachelor's Degree or equivalent combination of education and experience.
  • 6+ years of experience with compliance, oversight, & government relations.
  • 2+ years of experience leading a team.
  • Masters Degree preferred; will consider previous experience in health plan setting in government programs management (Contract Manager).
  • 8+ years of experience with compliance, oversight, government relations.
  • 4+ years of experience leading a team.
  • Competitive benefits and compensation package.
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