Job Details

JOB DESCRIPTION

Leads and directs team responsible 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

• Directs and oversees compliance activities and serves as a resource on compliance issues.

• Demonstrates leadership and expertise to ensure compliance with applicable state/federal statutes and internal policies.

• Facilitates training and education, and subject matter expertise related to compliance requirements.

• Ensures business accountability for compliance investigations - ensuring oversight, follow-up, and resolution.

• Enforces the compliance plan, code of conduct and anti-fraud plan.

• In conjunction with compliance leadership and the special investigative unit (SIU) team, develops an active relationship with third parties who have specific experience in conducting fraud, waste and abuse (FWA) investigations.

• Prepares written quarterly reports to inform compliance leadership on the status of activities pertaining to overall compliance for area(s) of responsibility.

• Oversees team of compliance professionals; responsible for hiring, performance management, recognition, and staff development. Job Requirements

• At least 8 years of experience in compliance, risk management, and/or auditing, or equivalent combination of relevant education and experience.

• At least 3 years management/leadership experience.

• Extensive knowledge of relevant regulatory frameworks and industry standards.

• Experience developing and implementing compliance programs and controls.

• Strong leadership, strategic thinking, and decision-making capabilities.

• 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.

• Strong verbal and written communication skills.

• Microsoft Office suite and applicable software program(s) proficiency. Preferred Qualifications

• Previous experience in a health plan or government programs setting (Medicaid, Medicare, Marketplace).

• Certificate in Healthcare Compliance (CHC), or other compliance-related certification.

To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.

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

Pay Range: $102,163 - $227,679 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.