(Sales) Compliance Analyst

JOB DESCRIPTION

Job Summary

Molina Healthcare\'s Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities.

KNOWLEDGE/SKILLS/ABILITIES

The Sales Compliance Analyst position is primarily responsible for Sales Oversight.

  • Provide regulatory expertise to the Sales Organization: both State and Federal

  • Have working knowledge of federal and state guidelines pertaining to Sales and Marketing.

  • Perform internal Sales/Marketing Compliance Reporting.

  • Perform internal Sales/Marketing monitoring.

  • Detailed oriented to conduct thorough Sales allegations investigations.

  • Recommend applicable corrective action(s) when applicable to business partners.

  • Process improvement driven.

  • Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.

  • Lead regularly scheduled Sales & Compliance leadership meetings.

  • Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications.

  • Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports.

  • Review and interpret internal Sales dashboards for outliers and deeper dive research.

  • Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found.

  • Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.).

  • Leads projects to achieve Sales compliance objectives.

  • Interprets and analyzes state and federal regulatory manuals and revisions.

  • Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight.

  • Interact with Molina external customers, via verbal and written communication.

  • Ability to work independently and set priorities.

JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS:

  • 2-4 years\' related compliance work experience

  • Exceptional communication skills, including presentation capabilities, both written and verbal.

  • Excellent interpersonal communication and oral and written communication skills.

  • High level Interaction with Leadership.

  • Sales Allegation Investigations

  • Policy & Procedures

PREFERRED QUALIFICATIONS:

  • BA/BS and/or CHC (Certified in Healthcare Compliance)

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: $77,969 - $116,835 / ANNUAL

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

Salary: USD 77969 - 116835 per year Experience: 3 years required
Back to blog