Manager, Compliance (Marketplace)
Molina Healthcare Florida; Idaho; Iowa; Georgia; Kentucky; Michigan; Nebraska; Ohio; Texas; Utah; Wisconsin; Washington; New York; New Mexico Job ID 2030343
Job Summary
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.
Job Duties
- 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. Targets may be based upon plans, federal or state requirements as dictated.
- 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.
Job Qualifications
REQUIRED EDUCATION:
Bachelor’s Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
6+ years of experience with compliance, oversight, & government relations.
2+ years of experience leading a team.
PREFERRED EDUCATION:
Masters Degree preferred; will consider previous experience in health plan setting in government programs management (Contract Manager)
PREFERRED EXPERIENCE:
8+ years of experience with compliance, oversight, government relations.
4+ years of experience leading a team.
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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: $80,412 - $188,164 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Posting Date: 03/21/2025ABOUT OUR LOCATION
View Map- Clinical Informatics Analyst (Data Analyst Experience) - REMOTE Gulfport Mississippi, Tampa Florida, Rochester New York, Syracuse New York, Texas, Utah, Bellevue Washington, Phoenix Arizona, Tucson Arizona, Orlando Florida, Atlanta Georgia, Cedar Rapids Iowa, Nampa Idaho, Ann Arbor Michigan, Warren Michigan, Buffalo New York, Cleveland Ohio, Houston Texas, Everett Washington, Kenosha Wisconsin, Savannah Georgia, Georgia, Boise Idaho, Bowling Green Kentucky, Sterling Heights Michigan, Kearney Nebraska, Bellevue Nebraska, Grand Island Nebraska, Nebraska, Omaha Nebraska, Cincinnati Ohio, Layton Utah, Madison Wisconsin, Chandler Arizona, Mesa Arizona, St. Petersburg Florida, Macon Georgia, Iowa City Iowa, Meridian Idaho, Lexington-Fayette Kentucky, Detroit Michigan, Albuquerque New Mexico, Dayton Ohio, West Valley City Utah, Hattiesburg Mississippi, Columbus Georgia, Sioux City Iowa, Owensboro Kentucky, Lincoln Nebraska, New Mexico, Rio Rancho New Mexico, Columbus Ohio, Spokane Washington, Vancouver Washington, Milwaukee Wisconsin, Southaven Mississippi, Biloxi Mississippi, Scottsdale Arizona, Jacksonville Florida, Idaho Falls Idaho, Caldwell Idaho, Roswell New Mexico, Yonkers New York, New York, Austin Texas, Dallas Texas, Racine Wisconsin, Green Bay Wisconsin, Miami Florida, Florida, Davenport Iowa, Des Moines Iowa, Covington Kentucky, Kentucky, San Antonio Texas, Orem Utah, Washington, Wisconsin, Augusta Georgia, Iowa, Idaho, Louisville Kentucky, Michigan, Grand Rapids Michigan, Las Cruces New Mexico, Santa Fe New Mexico, Albany New York, Ohio, Akron Ohio, Fort Worth Texas, Provo Utah, Salt Lake City Utah, Tacoma Washington 04/01/2025
- Director, Payment Integrity Bellevue Nebraska, New York, Ohio, San Antonio Texas, Utah, Kenosha Wisconsin, Racine Wisconsin, Tucson Arizona, Orlando Florida, Atlanta Georgia, Boise Idaho, Owensboro Kentucky, Louisville Kentucky, Kentucky, Warren Michigan, Michigan, Grand Rapids Michigan, Grand Island Nebraska, Buffalo New York, Syracuse New York, Houston Texas, Dallas Texas, Seattle Washington, Tacoma Washington, Spokane Washington, Phoenix Arizona, Florida, Miami Florida, Macon Georgia, Des Moines Iowa, Las Cruces New Mexico, Yonkers New York, Bellevue Washington, Tampa Florida, Iowa, Davenport Iowa, Idaho, Bowling Green Kentucky, Detroit Michigan, New Mexico, Akron Ohio, Columbus Ohio, Fort Worth Texas, West Valley City Utah, Orem Utah, Salt Lake City Utah, Milwaukee Wisconsin, Chandler Arizona, Lexington-Fayette Kentucky, Sterling Heights Michigan, Lincoln Nebraska, New York New York, Dayton Ohio, Austin Texas, Provo Utah, Layton Utah, Washington, Madison Wisconsin, Mesa Arizona, Georgia, Columbus Georgia, Cedar Rapids Iowa, Kearney Nebraska, Santa Fe New Mexico, Rochester New York, Vancouver Washington, St. Petersburg Florida, Savannah Georgia, Augusta Georgia, Sioux City Iowa, Omaha Nebraska, Albuquerque New Mexico, Wisconsin, Green Bay Wisconsin, Scottsdale Arizona, Jacksonville Florida, Iowa City Iowa, Idaho Falls Idaho, Caldwell Idaho, Ann Arbor Michigan, Nebraska, Roswell New Mexico, Rio Rancho New Mexico, Cincinnati Ohio, Cleveland Ohio, Texas, Nampa Idaho, Meridian Idaho, Covington Kentucky 03/28/2025
- Medical Economics Consultant - REMOTE St. Petersburg Florida, Rio Rancho New Mexico, Washington, Dallas Texas, Columbus Georgia, Utah, Orem Utah, Sterling Heights Michigan, Las Cruces New Mexico, Columbus Ohio, Sioux City Iowa, Albuquerque New Mexico, Austin Texas, Kentucky, San Antonio Texas, Roswell New Mexico, Grand Rapids Michigan, Rochester New York, Yonkers New York, Iowa, Buffalo New York, West Valley City Utah, Phoenix Arizona, Davenport Iowa, Tampa Florida, Tucson Arizona, Spokane Washington, Grand Island Nebraska, Tacoma Washington, Cedar Rapids Iowa, Savannah Georgia, Syracuse New York, Dayton Ohio, Santa Fe New Mexico, Michigan, Texas, Mesa Arizona, Chandler Arizona, Atlanta Georgia, Layton Utah, Houston Texas, Provo Utah, Salt Lake City Utah, Bowling Green Kentucky, Fort Worth Texas, Ohio, Des Moines Iowa, Bellevue Nebraska, Omaha Nebraska, Milwaukee Wisconsin, New York, Covington Kentucky, Kenosha Wisconsin, Bellevue Washington, Ann Arbor Michigan, Florida, Lexington-Fayette Kentucky, Scottsdale Arizona, Cleveland Ohio, Jacksonville Florida, Cincinnati Ohio, Georgia, Caldwell Idaho, Madison Wisconsin, Idaho, Iowa City Iowa, Boise Idaho, Meridian Idaho, Owensboro Kentucky, Green Bay Wisconsin, Miami Florida, Racine Wisconsin, Louisville Kentucky, Akron Ohio, Wisconsin, Augusta Georgia, Idaho Falls Idaho, Nampa Idaho, Nebraska, Detroit Michigan, Warren Michigan, Lincoln Nebraska, Long Beach California, New Mexico, Kearney Nebraska, Vancouver Washington 01/17/2025
- Medical Economics Consultant (Medicare) - REMOTE Bellevue Washington, Madison Wisconsin, Georgia, Iowa, Nebraska, Phoenix Arizona, Mesa Arizona, Orlando Florida, St. Petersburg Florida, Detroit Michigan, Las Cruces New Mexico, Santa Fe New Mexico, Rochester New York, Columbus Ohio, Austin Texas, Fort Worth Texas, Tacoma Washington, Racine Wisconsin, Florida, Idaho, Utah, Wisconsin, Atlanta Georgia, Savannah Georgia, Nampa Idaho, Cedar Rapids Iowa, Davenport Iowa, Sterling Heights Michigan, Ann Arbor Michigan, Roswell New Mexico, Yonkers New York, Milwaukee Wisconsin, Tucson Arizona, Miami Florida, Boise Idaho, Des Moines Iowa, Sioux City Iowa, Iowa City Iowa, Albuquerque New Mexico, Syracuse New York, Provo Utah, Michigan, Scottsdale Arizona, Jacksonville Florida, Columbus Georgia, Kearney Nebraska, Houston Texas, Layton Utah, Spokane Washington, Kenosha Wisconsin, Bowling Green Kentucky, Owensboro Kentucky, Lincoln Nebraska, Cleveland Ohio, Green Bay Wisconsin, Kentucky, Texas, Chandler Arizona, Augusta Georgia, Idaho Falls Idaho, Caldwell Idaho, Covington Kentucky, Bellevue Nebraska, Rio Rancho New Mexico, Orem Utah, New York, Ohio, Tampa Florida, Macon Georgia, Lexington-Fayette Kentucky, Cincinnati Ohio, Grand Rapids Michigan, Omaha Nebraska, Buffalo New York, Akron Ohio, Salt Lake City Utah, Vancouver Washington, New Mexico, Washington, Meridian Idaho, Louisville Kentucky, Warren Michigan, Grand Island Nebraska, Dayton Ohio, Dallas Texas, West Valley City Utah, San Antonio Texas 01/06/2025