Job Description
Job Description
Work Location - Remote, work from home within the US.
Job Summary
Provide oversight for the Marketplace 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 Marketplace 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 Marketplace Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the enterprise while ensuring compliance with governmental requirements for assigned states.
• Ensures implementation of Marketplace compliance policies and procedures, and monitoring plans for business areas. Identify training opportunities and collaboration opportunities to enhance the Marketplace Compliance program.
• Lead and/or collaborate with Health Plan Compliance Officers on Marketplace external regulatory audits.
• Serve as a resource for Marketplace compliance inquiries, and regulatory advisement for assigned states
• 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.
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 - Marketplace 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: $60,4150-$117,809 a year*
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Description
Work Location - Remote, work from home within the US.
Job Summary
Provide oversight for the Marketplace 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 Marketplace 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 Marketplace Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the enterprise while ensuring compliance with governmental requirements for assigned states.
• Ensures implementation of Marketplace compliance policies and procedures, and monitoring plans for business areas. Identify training opportunities and collaboration opportunities to enhance the Marketplace Compliance program.
• Lead and/or collaborate with Health Plan Compliance Officers on Marketplace external regulatory audits.
• Serve as a resource for Marketplace compliance inquiries, and regulatory advisement for assigned states
• 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.
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 - Marketplace 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: $60,4150-$117,809 a year*
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.