Medicare Compliance Manager (Medicare Advantage Required) - REMOTE

Remote Full-time
Job Description 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. Apply tot his job
Apply Now →

Similar Jobs

Health Coach- Remote

Remote

Regional Manager, Clinical Documentation Integrity job at Trinity Health in Livonia, MI

Remote

Health Information Specialist I - Kalamazoo, MI

Remote

Remote Contract Epic + 3M Inpatient Coder

Remote

[Remote] Epic Tapestry Application Analyst

Remote

Health Insurance Biller

Remote

Public Health Strategy, Policy, and Operations Expert Bethesda, MD

Remote

Clinical Appeals Auditor -LPN; Remote

Remote

Healthcare Analytics Business Consultant (SQL / Python) 18 Locations

Remote

Clinical Laboratory Informatics Consultant-Remote supporting territory aligned to Dallas, TX

Remote

Experienced Full Stack Pharmacy Professional – Remote Patient Care, Medication Management, and Pharmacy Operations at Blithequark

Remote

Field Social Worker (REMOTE) Job at BRICK Networks in Newark

Remote

Product Designer & Research Lead - Teen Social Engagement App

Remote

**Experienced Live Chat Support Specialist – Work from Home Opportunity with blithequark**

Remote

Product Manager

Remote

Experienced Remote Data Entry Specialist and Customer Service Representative – Flexible Part-Time Opportunity for Career Growth and Development

Remote

**Experienced Data Entry Support Specialist – Remote Contract Position at blithequark**

Remote

Part Time Merchandising Services Associate - Days: Shaping the Future of Home Improvement at Lowe's

Remote

VQI Data Abstractor: Part-Time

Remote

Experienced Data Entry Specialist for Logistics Operations – Remote Work Opportunity with arenaflex

Remote
← Back