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.
路 Provide regulatory expertise to the Sales Organization: both State and Federal
路 Have working knowledge of federal and state guidelines pertaining to Sales and Marketing.
路 Perform internal Sales/Marketing Compliance Reporting.
路 Perform internal Sales/Marketing monitoring.
路 Detailed oriented to conduct thorough Sales allegations investigations.
路 Recommend applicable corrective action(s) when applicable to business partners.
路 Process improvement driven.
路 Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.
路 Lead regularly scheduled Sales & Compliance leadership meetings.
路 Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications.
路 Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports.
路 Review and interpret internal Sales dashboards for outliers and deeper dive research.
路 Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found.
路 Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.).
路 Leads projects to achieve Sales compliance objectives.
路 Interprets and analyzes state and federal regulatory manuals and revisions.
路 Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight.
路 Interact with Molina external customers, via verbal and written communication.
路 Ability to work independently and set priorities.
Experience
路 2-4 years' related compliance work experience
路 Exceptional communication skills, including presentation capabilities, both written and verbal.
路 Excellent interpersonal communication and oral and written communication skills.
路 High level Interaction with Leadership.
Sales Allegation Investigations
Policy & Procedures
Pay Range: $77,969 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.