Provides senior level 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 coordinating, conducting and/or responding to research requests pertaining to government health care programs, preparing and submitting regulatory reports for filings, reviewing plan submissions for quality, accuracy and timeliness, and ensuring plan meets contractual and regulatory requirements.
Reviews provider agreements, evidence of coverage (EOC), member handbook, provider directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission.
Assesses information received from government contracting agencies and regulators and disseminates to impacted plan staff.
Participates in meetings related to Molina government run programs with state agencies and Molina corporate departments and disseminates relevant information to staff and leadership.
Oversees/maintains the department's documentation and archive system - ensuring submitted reports are archived for historical and audit purposes; ensures system is updated and complete.
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 3 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and at least 1 year of experience in government contracts, 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
Compliance-related experience.
Proficient in analysis and summarization of draft legislation, administrative rules and other regulatory drafts.
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
Numbers & Facts
Location
Des Moines, IA
Skills
Analysis Skillsunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Contract Creationunmatched
Contract Managementunmatched
Contract Requirementsunmatched
Cross-Functionalunmatched
Data Analysisunmatched
Data Collectionunmatched
Detail Orientedunmatched
Document Archivingunmatched
Federal Governmentunmatched
Governmentunmatched
Government Contractsunmatched
Government Fundingunmatched
Health Insuranceunmatched
Healthcareunmatched
Interpersonal Skillsunmatched
Leadershipunmatched
Marketingunmatched
Medicaidunmatched
Medicareunmatched
Microsoft Officeunmatched
Multitaskingunmatched
Presentation/Verbal Skillsunmatched
Project/Program Managementunmatched
Regulationsunmatched
Regulatory Complianceunmatched
Regulatory Reportsunmatched
Regulatory Requirementsunmatched
Regulatory Submissionsunmatched
Reporting Skillsunmatched
State Governmentunmatched
Systems Maintenanceunmatched
Time Managementunmatched
Writing Skillsunmatched
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