JOB DESCRIPTION

Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk related to fraudulent or abusive practices.

Essential Job Duties

• Performs on-going compliance audits utilizing as necessary, state evaluation tools relating to audit/monitoring activities.
• Identifies and defines audit scope and criteria, reviews and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified.
• Provides comprehensive advice to assigned departments regarding compliance risks with respect to federal and state regulations and contract provisions.
• Provides input and support during the annual risk assessment and audit planning processes.
• Assists with monitoring activities involving the effect...