Medicare Compliance Analyst

Molina Healthcare
Macon, GA
**JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsible for Medicare Oversight. + Provide regulatory expertise to the Organization: both State and Federal + Have working knowledge of federal and state guidelines pertaining to Medicare Advantage (MA) products. + Perform internal MA Compliance Reporting. + Perform internal monitoring. + Detailed oriented to conduct thorough research. + Recommend applicable corrective action(s) to business partners. + Process improvement driven. + Create, update, and retire P&Ps, Standard Operating Procedures and Training documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards for outliers and deeper dive research when applicable. + Lead projects to achieve compliance objectives. + Interpret and analyze State and Federal Regulatory rules, manuals and revisions. + Interact with internal stakeholders via verbal and written communication. + Ability to work independently and set priorities. + Foster an environment of open communication with business partners. **EXPERIENCE** + 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. + Writing Policy & Procedures + Project Management experience is highly preferred. **REQUIRED EDUCATION** : + Bachelor's degree and/or equivalent combination of relevant education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 2- 4 years' experience in compliance related work **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : **PREFERRED EDUCATION** : **PREFERRED EXPERIENCE** : + 1-3 years' experience in the health care industry + Managed Care Experience 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.
Posted 2025-11-22

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