Healthcare Services Operations Support Auditor

JOB DESCRIPTION Job Summary Provides support for non-clinical healthcare services auditing activities. Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.Essential Job Duties • Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements. • Reports outcomes, identifies areas of re-training for staff, and communicates findings to leadership. • Ensures auditing approaches follow a Molina standard in approach and tool use. • Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA). • Demonstrates professionalism in all communications. • Adheres to departmental standards, policies, protocols. • Maintains detailed records of auditing results. • Assists healthcare services with developing training materials or job aids as needed to address findings in audit results. • Meets minimum production standards related to non-clinical auditing. • May conduct staff trainings as needed. • Communicates with quality, and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.Required Qualifications • At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience. • Strong analytical and problem-solving skills. • Ability to work in a cross-functional, professional environment. • Ability to work on a team and independently. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency.Preferred Qualifications • Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing experience.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 Pay Range: $24 - $56.17 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-09-29