Director, Operational Oversight

Molina Healthcare • Cedar Rapids, IA • 2w ago

Job Description

Job Summary

Responsible for planning, developing and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve

Knowledge/Skills/Abilities

Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of internal compliance audits, represent Corporate Operations on external regulatory or associated audits, oversee function support areas requiring consistent oversight. May include travel up to 25%.

Primary liaison between regulatory auditors and corporate operations business units, leadership and line personnel from receipt of notification from regulatory agency through analysis and response to findings.

Organize audit submissions, interact directly with auditors for all lines of business as it relates to audits.

Delegation Oversight; voting representative for delegation oversight committees.

Liaison to Special Investigative Unit regarding program integrity and oversight cost expenditure.

Monitor internal compliance of Corporate Operations units via establishment of an internal compliance program, including annual, periodic, focal, etc. audits.

Request, review and perform oversight of internal corrective action plans (CAPs) for both internal and external audit findings via coordination of responses to assure appropriateness as it relates to the finding.

Performs support via review and approval for Corporate Operations policies, procedures, guidelines and job aids to assure compliance with corporate or state regulations.

Develop and maintain Corporate Operations Compliance program, including compliance policies, procedures and implementation of audits and monitoring.

Corporate Operations liaison to Corporate Legal to address legal actions, e.g. third party liability suits, provider and other such member suits.

Maintain an awareness of current laws, regulations, statutes, etc. for each state that Molina operates in that impacts Corporate Operations compliance.

Analyze and interpret with possible assistance from Molina Health Plans regulations that affect Corporate Operations policies, procedures and guidelines and work with internal leadership to assure inclusion in such documents.

Liaison for health plans for all OIG, OAG and other state office of internal/attorney general requests for data.

Liaison with the corporation's special investigative unit.

Assists with Request for Proposal responses.

Proactively work with Corporate Operations leadership on operational effective to assure compliance.

Persuade and instill effective cooperation to assure compliance via developing rapport with health plan compliance and government contract personnel..

Job Qualifications

Required Education

Bachelor's Degree or equivalent years of experience in Healthcare Administration such as oversight, audit, etc.

Required Experience

7 years of managed care experience (Regulatory and Compliance)

Previous management experience of 5 years or more

Preferred Education

Master's Degree in Healthcare Administration

Preferred Experience

10 years of managed care experience (Regulatory and Compliance)

Previous management experience of 5 years or more

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.

Pay Range: $101,721 - $206,981 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Manager, Operations (Remote)

Molina Healthcare • Cedar Rapids, IA • 17h ago

Management & Administrative

Job Description Job Summary Provides leadership and direction to MMS Operational Units management staff (e.g., Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider Network), for manag...

17h ago

Go to Apply

Account Manager

Mississippi Valley Regional Blood Center • Cedar Rapids, IA • 18h ago

Management & Administrative

Are you passionate about making a difference in our community? Join the ImpactLife team to help us Change the World. We are looking for committed individuals who demonstrate good character, use clear communication, and c...

18h ago

Go to Apply

Accountant

Robert Half • Hiawatha, IA • 22h ago

Finance, Accounting & Banking

Description Are you an experienced accountant looking to take on a dynamic and impactful role in the construction industry? We're seeking a skilled Accountant to join our team and contribute to the financial management o...

22h ago

Go to Apply

2nd Grade

Cedar Rapids Community School District • Cedar Rapids, IA • 1d ago

2nd Grade JobID: 14613 Position Type: Elementary School Teaching/ Primary - Grades 1, 2, 3 Date Posted: 7/29/2025 Location: Trailside Elementary School Date Available: 2025-2026 School Year SUMMARY:Provides instruction i...

1d ago

Go to Apply

Operations Manager - Inventory Control & Quality Assurance - Cedar Rapids Fulfillment Center

Nordstrom • Cedar Rapids, IA • 1d ago

Management & Administrative

Job Description Schedule: B Shift, Tue-Fri, 4:00PM-2:00AM The ideal Inventory Integrity & Quality Manager is a versatile, results oriented leader with strong communication and partnering skills. This position will le...

1d ago

Go to Apply

Entry Level Recruiter/Sales Trainee

Aerotek • Cedar Rapids, IA • 1d ago

Management & Administrative

Overview Why Aerotek? Aerotek is an operating company within Allegis Group, a global leader in talent solutions. We are a privately held organization with over 200+ offices nationwide. We work with 95% of Fortune 500 com...

1d ago

Go to Apply

Medical Assistant

Actalent • Cedar Rapids, IA • 2d ago

Hospital & Medical

Job Title: Medical AssistantJob Description We are seeking a dedicated Medical Assistant to join our team, providing comprehensive support in a dermatology setting. This role involves assisting the dermatologist with var...

2d ago

Go to Apply

Activities Coordinator

Care Initiatives • Cedar Rapids, IA • 2d ago

Heritage Specialty Care , a 201-bed long-term care skilled nursing community located in Cedar Rapids, IA, is now hiring! Are you a compassionate Activities Professional looking to make a meaningful difference in the live...

2d ago

Go to Apply

341 Test Technician 2nd Shift (Onsite)

RTX Corporation • Cedar Rapids, IA • 2d ago

IT & Engineering

Date Posted: 2025-07-28 Country: United States of America Location: HIA32: Cedar Rapids, IA 400 Collins Rd NE , Cedar Rapids, IA, 52498-0505 USA Position Role Type: Onsite U.S. Citizen, U.S. Person, or Immigration Status...

2d ago

Go to Apply

Market Grille Clerk

Hy-Vee Food Stores • Cedar Rapids, IA • 2d ago

Management & Administrative

Additional Considerations (if any): - At Hy-Vee our people are our strength. We promise "a helpful smile in every aisle" and those smiles can only come from a workforce that is fully engaged and committed to supporting o...

2d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.