Lead, Government Contracts (Managed Care Required) - MA ONLY

Molina Healthcare • Springfield, MA • 2h ago

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.

PJCorp

LI-AC1

Pay Range: $64,350 - $128,519 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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