JOB DESCRIPTION
Job Summary
Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.
KNOWLEDGE/SKILLS/ABILITIES
- Leads the day-to-day oversight and monitoring of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, duals (MMP) and Marketplace
- Acts as the lead internal contact for informational requests and contract research
- Leads daily government contracts activities to ensure contractual compliance with regulatory agencies for all lines of business (Medicaid, MMP and Marketplace)
- Secures timely submission of all required reports
- Works with the health plan's departments on state requirements and inquiries
- Ensures accuracy, timeliness and completion of ad hoc regulatory inquiries/requests, marketing material submissions, policies, and procedures, etc.
- Assists with audits in coordination with the compliance department
- Maintains and updates regulatory work plans, including state regulatory guidance documents and state rules
- Maintains consistent processes for all lines of business within the Government Contracts department
- Maintains calendar and databases documenting regulatory filings
- Coordinates with other departments in resolution process. Maintains log to ensure prompt and timely resolution
- Conducts research on government programs and state requirements as needed
- Maintains Government Contracts SharePoint site to store regulatory correspondence/reports/materials and ensure accessibility of information to staff
- Participates in review of contract and regulatory requirements
- Coordinates the maintenance, review, and dissemination of company policies and procedures
- Leads the development and deployment of training programs related to government contract requirements
- Some travel may be required.
JOB QUALIFICATIONS
Required Education
Bachelor's degree or equivalent combination of education and experience
Required Experience
- Minimum of five (5) years’ experience in a managed care environment (including Medicare, Medicaid and other State governed plans)
- Minimum of four (4) years of health insurance experience
- Minimum of two (2) years of Government Contracts experience
- Knowledge of Medicare compliance requirements
Preferred Education
Bachelor's Degree in Business Administration, Healthcare or related field.
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.
Pay Range: $49,430.25 - $107,098.87 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
