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Employee Compliance Certificate Acknowledgement Form
1. This certifies that <<name of employee>>
have successfully submitted the electronic acknowledgement form for
<<name of course/packet>>
on <<date of comletion>>.
The employees acknowledges he/she fully understands his/her program
obligations to and will report to the designated Compliance Officer, other
appropriate organization representative or the Compliance Alertline any
potential or suspected violations of the laws, regulations, or program
requirements governing the operations and conduct of Molina Healthcare.
Certificate of Acknowledgement
Wanda I Rodriguez Alvarez
Compliance Packet - Puerto Rico
March 4, 2015