JOB DESCRIPTION 

Leads and directs team responsible for compliance activities. Seeks to ensure the organization adheres to regulatory requirements, industry standards, and Molina internal policies, and prevents and/or detects violation of applicable laws and regulations, and protect the business from liability, fraudulent or abusive practices. 

Essential Job Duties 

• Directs and oversees compliance activities and serves as a resource on compliance issues. 
• Demonstrates leadership and expertise to ensure compliance with applicable state/federal statutes and internal policies. 
• Facilitates training and education, and subject matter expertise related to compliance requirements. 
• Ensures business accountability for compliance investigations - ensuring oversight, follow-up, and resolution. 
• Enforces the compliance plan, code of conduct and anti-fraud plan. 
• In conjunction with compliance leadership and the special investigative unit (SIU) team, develops an active relationship with third parties who have specific experience in conducting fraud, waste and abuse (FWA) investigations. 
• Prepares written quarterly reports to inform compliance leadership on the status of activities pertaining to overall compliance for area(s) of responsibility. 
• Oversees team of compliance professionals; responsible for hiring, performance management, recognition, and staff development. Job Requirements 
• At least 8 years of experience in compliance, risk management, and/or auditing, or equivalent combination of relevant education and experience. 
• At least 3 years management/leadership experience. 
• Extensive knowledge of relevant regulatory frameworks and industry standards. 
• Experience developing and implementing compliance programs and controls. 
• Strong leadership, strategic thinking, and decision-making capabilities. 
• Ability to thrive in a cross-functional highly matrixed environment. 
• Strong analytical and problem-solving skills. 
• Project management experience. 
• Ability to build rapport and gain the respect and collaboration of internal/external stakeholders. 
• Knowledge and ability to think creatively, proactively, and independently. 
• Ability to prepare reports and presentations and manage data. 
• Self-motivated and results oriented. 
• Strong organizational skills and the ability to meet delivery targets. 
• Disciplined and ability to effectively track, document and report on projects/activities. 
• Strong verbal and written communication skills. 
• Microsoft Office suite and applicable software program(s) proficiency. Preferred Qualifications 
• Previous experience in a health plan or government programs setting (Medicaid, Medicare, Marketplace). 
• Certificate in Healthcare Compliance (CHC), or other compliance-related certification. 



To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board. 

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V