Director, Compliance (Nevada Health Plan) - Remote in ...

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 u2022 Directs and oversees compliance activities and serves as a resource on compliance issues. u2022 Demonstrates leadership and expertise to ensure compliance with applicable state/federal statutes and internal policies. u2022 Facilitates training and education, and subject matter expertise related to compliance requirements. u2022 Ensures business accountability for compliance investigations - ensuring oversight, follow-up, and resolution. u2022 Enforces the compliance plan, code of conduct and anti-fraud plan. u2022 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. u2022 Prepares written quarterly reports to inform compliance leadership on the status of activities pertaining to overall compliance for area(s) of responsibility. u2022 Oversees team of compliance professionals; responsible for hiring, performance management, recognition, and staff development. Job Requirements u2022 At least 8 years of experience in compliance, risk management, and/or auditing, or equivalent combination of relevant education and experience. u2022 At least 3 years management/leadership experience. u2022 Extensive knowledge of relevant regulatory frameworks and industry standards. u2022 Experience developing and implementing compliance programs and controls. u2022 Strong leadership, strategic thinking, and decision-making capabilities. u2022 Ability to thrive in a cross-functional highly matrixed environment. u2022 Strong analytical and problem-solving skills. u2022 Project management experience. u2022 Ability to build rapport and gain the respect and collaboration of internal/external stakeholders. u2022 Knowledge and ability to think creatively, proactively, and independently. u2022 Ability to prepare reports and presentations and manage data. u2022 Self-motivated and results oriented. u2022 Strong organizational skills and the ability to meet delivery targets. u2022 Disciplined and ability to effectively track, document and report on projects/activities. u2022 Strong verbal and written communication skills. u2022 Microsoft Office suite and applicable software program(s) proficiency. Preferred Qualifications u2022 Previous experience in a health plan or government programs setting (Medicaid, Medicare, Marketplace). u2022 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 Pay Range: $102,163 - $227,679 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2026-02-23