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.

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.

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 Full Time

• 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