Job Description

JOB DESCRIPTION

Job Summary

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.

KNOWLEDGE/SKILLS/ABILITIES

• Performs on-going compliance audits by creating/developing audit tools relating to audit/monitoring activities.
• Research and apply Federal, State, and contractual requirements specific to audit/monitoring activities.
• Identifies and defines audit scope and criteria, reviews, and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified.
• Communicate (verbal and written) audit results professionally to all levels of leadership.
• Provides recommendations to departments regarding compliance risks with respect to Federal and State regulations and contract provisions.
• Provides input during the annual risk assessment and audit planning processes.
• Assists with monitoring activities involving the effective execution of corrective action requirements imposed by state or federal regulatory agencies for contract deficiencies.

JOB QUALIFICATIONS

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

1-3 years Audit

Preferred Education

Bachelor's degree in health care related area.

Preferred Experience

3-5 years Audit

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.

Job Info

Job Identification: 2025109

Job Category: Legal, Risk, & Compliance

Posting Date: 2024-06-03T17:54:02 00:00

Job Schedule: Full time