Job Description
JOB DESCRIPTION
Leads and directs team responsible for government contracts activities. Responsible for 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 in designated Molina markets.
Essential Job Duties
- Leads and directs team responsible for management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, Medicare, duals Medicare-Medicaid Program (MMP) and Marketplace, including reviewing and implementing new program requirements and ensuring the plan complies with all health plan contractual and regulatory reporting requirements.
- Serves as the lead for health care program contractual and regulatory requirements, including performing the initial assessment and overseeing the implementation of all proposed and new contractual and regulatory standards, and ensuring the plan meets all filing requirements and ad hoc reporting requests in a timely manner and with quality deliverables.
- Hires, onboards, trains, develops, mentors and performance manages reporting team of government contracts professionals and demonstrates accountability for team goals/deliverables.
- Manages contract renewal activities.
- Leads project teams involving staff from across the plan to implement new standards for which the government contracts department is accountable or otherwise involved.
- Chairs committees and leads workgroups to carryout assigned responsibilities.
- Assesses proposed state laws and regulations to determine potential impact, and provides written reports of findings to requesting plan and or corporate staff.
- Develops department staff to serve as product line subject matter experts in research standards and program requirements.
- Serves as a key liaison with state health care agencies and regulators.
- Coordinates plan responses/reports to state health care agencies, regulators and partners regarding contractual and regulatory issues.
- Identifies potential new business and bid opportunities.
Required Qualifications
- At least 8 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and 5 years of experience in government health programs, or equivalent combination of relevant education and experience.
- At least 3 years management/leadership experience.
- Strong knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance.
- Ability to work cross-functionally in a highly matrixed environment.
- Strong interpersonal skills.
- Strong organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
- Analytical reasoning ability and detail orientation.
- Proficient in compiling data, creating reports, and presenting information.
- Excellent verbal and written communication skills, including ability to communicate and present to internal and external stakeholders.
- Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
- Legal/compliance-related experience.
- Strong Medicaid-specific experience.
- Experience with state/federal government relations and relationship building with key governmental representatives.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHPO
#LI-AC1
Job Tags
Full time, Work at office, Remote work