Medicare Compliance Manager - Military Veterans
at Molina Healthcare
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
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.
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
5-7 years
Preferred Education
Masters Degree preferred; will consider previous experience in health plan setting in government programs management (Contract Manager)
Preferred Experience
7-9 years
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: $59,810.6 - $129,589.63 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Madison, WI
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.