Job Information
Molina Healthcare Lead, Government Contracts - Regulatory Contractual Requirements - Remote in Texas
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.
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