• Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules. • Document all findings referencing the appropriate policies and rules. • Generate letters articulating audit findings. • Supporting your findings during the appeals process if requested. • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse. • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits. • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients. • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members. • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines. • Interface with and support the Medical Director and cross train in all clinical departments/areas. • Other duties as required to meet business needs.

• The Senior Lead Internal Auditor leads audits by planning, performing and reporting on auditing activities • Reviews and evaluates the design and operating effectiveness of internal controls • Reviews and oversees the work of audit staff and communicates audit results to management • Supports operational audits with emphasis on environmental, health, and safety compliance and landfill operations • Plans and performs reviews of corporate and field processes; prepares audit programs and work papers • Acts in a leading role when planning and scoping corporate audits based upon an understanding of relevant processes • Discusses audit results with senior level management in both written and verbal formats and recommends corrective action • Examines Company processes and systems by evaluating control risks/gaps • Participates in defining and refining audit procedures • Leads the planning phase of an audit relating to the proposed scope of Internal Audit testing

Role 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. - 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 effective execution of corrective action requirements imposed by state or federal regulatory agencies for contract deficiencies. Qualifications - At least 2 years experience in audit and/or compliance, or equivalent combination of relevant education and experience. - Knowledge of relevant regulatory frameworks and compliance standards. - Understanding of internal control concepts and risk assessment methodologies. - Strong analytical and problem-solving abilities. - Attention to detail, and ability to manage multiple projects simultaneously. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software program(s) proficiency. Requirements - Experience in the health care industry (preferred). Benefits - Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

• Lead IT SOX program from scoping through reporting, serving as the primary contact for testing execution, timeline, and external auditor coordination. • Perform automated and IT general controls testing in support of the SOX compliance program • Collaborate with functional teams to evaluate current and new processes, advise management on control design, and identify risks and improvement areas • Partner with Compliance to ensure IT SOX documentation, including flowcharts, narratives, and controls are up to date, accurate and properly handled as part of process redesigns and system implementation efforts • Develop and maintain audit workpapers and documentation, including audit plans, testing procedures, and results • Conduct interviews and walkthrough meetings of internal stakeholders • Prepare internal audit reports and communicate results and recommendations to internal stakeholders • Monitor the remediation of identified control deficiencies and track progress towards remediation objectives • Provide clear and concise updates to your lead on the status of assignments