This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description - Provide direct oversight of escalated queries and complaints - Collate responses to regulatory bodies - Identify areas of high risk through evaluation of all queries logged and resolved - Minimise the volume of risk-related queries - Maintain and update accurate records of all risk-related queries - Liaise with stakeholders and departments to resolve risk management issues - Implement controls, procedures, and reports as requested by senior management - Perform other functions and tasks as requested by management, ensuring alignment with company goals and risk management strategies - Ensure all regulatory queries such as credit balance, prescription, and balance disputes are dealt with in accordance with relevant legislation, irrespective of the department where the query is managed Qualifications - Minimum qualification: Matric - A tertiary qualification in Legal, Compliance, or Risk Management is advantageous - Understanding of key regulatory frameworks, such as the National Credit Act and Consumer Protection Act - Minimum of 3 years in a supervisory experience in an operational function - Experience working within a risk, compliance, or legal environment - Strong attention to detail and analytical thinking - Ability to work independently with minimal supervision - Excellent communication and problem-solving skills - High level of EQ and ability to negotiate using persuasion skills - High proficiency in MS Word, MS Excel, MS Outlook, and risk management systems Requirements - Minimum qualification: Matric - A tertiary qualification in Legal, Compliance, or Risk Management is advantageous - Understanding of key regulatory frameworks, such as the National Credit Act and Consumer Protection Act - Minimum of 3 years in a supervisory experience in an operational function - Experience working within a risk, compliance, or legal environment - Strong attention to detail and analytical thinking - Ability to work independently with minimal supervision - Excellent communication and problem-solving skills - High level of EQ and ability to negotiate using persuasion skills - High proficiency in MS Word, MS Excel, MS Outlook, and risk management systems Benefits - Market Related Salary - Work From Home

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina’s Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause analysis. Job Duties - Works with assigned health plan to capture and document requirements, build custom health plan reports, and educate health plan users on how to use reports - Builds intervention strategy reporting for the Risk and Quality interventions and measures gap closure - Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring - Develops and QA custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP - Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates - Assists and collaborates with the national Risk and Quality department with testing of pre-production reporting for the assigned health plan - Calculates and tracks gap closure and intervention outcome reporting for the assigned state - Works in an agile business environment to derive meaningful information out of complex and large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis - Conducts root cause analysis for business data issues - Analyzes data sets and trends for anomalies, outliers, trend changes, and opportunities, using databricks SQL, PowerBi, excel, and techniques to determine significance and relevance - Assists with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations - Key partner to assist with testing changes in the Datawarehouse platform and perform transparent upgrades to reporting modules to ensure no impact to the end users - Conducts preliminary and post impact analyses for any logic and source code changes for data and reporting module keeping other variables as constant that are not of focus - Develops oneself as a HEDIS subject matter expert to help health plan improve performance on underperforming measures Job Qualifications REQUIRED QUALIFICATIONS: - Bachelor's Degree or equivalent combination of education and work experience - 3-5 years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data - 3-5 years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design - 3-5 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI - 1-3 years of experience with Microsoft Azure, AWS, or Hadoop - 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment - 3-5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics 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 #PJCorp #LI-AC1

Req ID: 356626 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Risk & Compliance Senior Director Consulting Practice Lead to join our team in Charlotte, North Carolina (US-NC), United States (US). Our Risk & Compliance Consulting team is composed of seasoned management consultants who help clients across industries navigate today’s complex risk management and compliance landscape. We support organizations in protecting institutional assets, enhancing operational efficiency, and mitigating threats to business profitability. Our practice specializes in operational risk management, internal and external compliance, financial crimes prevention, and digital fraud solutions. As a Senior Director Practice Lead, you will serve as a strategic leader within our growing practice. You’ll work hands-on with clients—ranging from top U.S. banks and global payment providers to leading wealth management firms—to help them achieve their digital, data, and transformational goals. With NTT DATA's global footprint, you’ll have the opportunity to engage in impactful work across industries and potentially across countries. This is a highly visible leadership role with opportunities to shape offerings, develop thought leadership, drive practice growth, and establish long-term client relationships. Responsibilities: - Lead, manage, and grow the Risk & Compliance consulting practice. - Oversee the delivery of the largest and most complex client engagements. - Collaborate with executive leadership to set organizational strategy and business objectives. - Influence long-term strategic focus and drive both tactical and transformational change. - Serve as a trusted advisor to executive stakeholders, providing expert-level consulting and subject matter expertise. - Deliver thought leadership and innovative, leading-edge consulting solutions. - Guide clients on business strategy, technology strategy, and prioritization based on industry trends. - Build and maintain strong relationships with C‑suite executives in targeted organizations. - Contribute to solution development and strategic decision-making across the organization. Qualifications: - 15+ years of experience in Risk & Compliance, including direct business development, client relationship management, and talent development. - 8+ years of experience in a Management Consulting firm (Big 4 preferred) with strong customer engagement and delivery oversight. - 5+ years’ experience: - Credit experience in at least one of the following areas: - Institutional, Corporate, or Commercial credit across all products - Commercial, Corporate & Markets Loan Workout across major credit cycles - Risk appetite, governance, and limits management - Fraud, waste, and abuse - Data and customer privacy - Personal credit signing authority - Enterprise Risk Management experience, including: - Designing and executing risk management frameworks (including regulatory remediation) - Risk identification across operational, reputational, financial crime, and compliance domains - Financial crimes, fraud, risk, and resilience - 5 + years of Risk experience in one or more of the following segments: - Banking & Financial Services - Life Sciences - Healthcare - Manufacturing - Commercial/Consumer sectors - Bachelor’s degree in business or a related discipline. Preferred Skills: - Experience working with global, cross-functional teams. - Product design and configuration expertise. - Graduate degree (MBA, MS, JD) preferred but not required. Why Join Us? - Opportunity to build and lead a high-impact consulting practice. - Work with top-tier clients in financial services and beyond. - Exposure to diverse projects and global collaboration. - A culture that values innovation, leadership, and continuous learning. #LI-NorthAmerica About NTT DATA NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients’ long-term success. Visit nttdata.com or LinkedIn to learn more. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is $216,405 – 480,900. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate’s actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life and AD&D insurance, short and long term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.

• Develop and maintain TD’s AML/ATF/Sanctions/ABAC programs • Conduct periodic and event driven reviews of customers • Manage and escalate issues related to risk assessment