AZ, United States
28 days ago
Analyst, Compliance (Sales)

(Sales) Compliance Analyst

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.

 

· Provide regulatory expertise to the Sales Organization: both State and Federal

· Have working knowledge of federal and state guidelines pertaining to Sales and Marketing.

· Perform internal Sales/Marketing Compliance Reporting.

· Perform internal Sales/Marketing monitoring.

· Detailed oriented to conduct thorough Sales allegations investigations.

· Recommend applicable corrective action(s) when applicable to business partners.

· Process improvement driven.

· Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.

· Lead regularly scheduled Sales & Compliance leadership meetings.

· Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications.

· Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports.

· Review and interpret internal Sales dashboards for outliers and deeper dive research.

· Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found.

· Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.).

· Leads projects to achieve Sales compliance objectives.

· Interprets and analyzes state and federal regulatory manuals and revisions.

· Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight.

· Interact with Molina external customers, via verbal and written communication.

· Ability to work independently and set priorities.

 

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.

· Sales Allegation Investigations

· Policy & Procedures

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