Specialist, Government Contracts (MA State Health Plan)

Job description

Job Summary

Provides support for government contracts activities. Responsible for the 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

• Supports government contracts activities including maintenance of state correspondence and regulatory databases, communication of deliverables/submission between staff and governmental agencies, policy and procedure maintenance and review, and contract review.
• Maintains calendar and databases documenting regulatory filings, approvals of member materials, member/provider inquires and ad hoc regulatory requests.
• Responds to inquiries from government agencies regarding plan issues and requirements coordinates with other applicable departments in resolution process and maintains log to ensure prompt and timely resolution.
• Conducts research on government-specific programs and state requirements.
• Assists in maintenance of 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.
• Assists in development and deployment of training programs related to government contracts requirements.
• Conducts structured evidence reviews/audits of new regulatory mandates contract amendments and other operational implementations, and verifies that Molina business units have implemented required changes.

Required Qualifications

• At least 1 year of experience in a managed care environment - preferably in a government sponsored Medicaid setting, or equivalent combination of relevant education and experience.
• Knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance.
• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Detail oriented and analytical reasoning abilities.
• Proficient in analyzing and compiling data, creating reports, and presenting information.
• Ability to work cross-functionally in a highly matrixed environment.
• Effective verbal, written, and interpersonal communication skills, including ability to communicate and present to internal and external stakeholders.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Medicaid, Medicare, and/or Marketplace government programs experience.
• Compliance-related experience.

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