Director, Government Contracts (Marketplace Regulatory)

Molina Healthcare•Long Beach, CA

About The Position

Responsible for facilitating all regulatory requirements to become certified in the Federally Facilitated Exchange and State Based Exchanges, and support to the Marketplace line of business in maintaining state and federal regulatory compliance.

Requirements

At least 8 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and 5 years of experience in government contracts, 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.

Nice To Haves

Legal/compliance-related experience.
Strong Medicaid-specific experience.
Experience with state/federal government relations and relationship building with key governmental representatives.
Knowledge of the Affordable Care Act, State insurance laws and regulations in Connecticut, Kentucky, Idaho, Michigan, South Carolina, and Utah.

Responsibilities

Responsible for leading a team that supports the regulatory function for the Marketplace line of business.
Serves as the lead for Federal and State regulatory filings and submissions, including performing the initial assessment of requirements and ensuring the Plan meets all filing requirements and ad hoc reporting requests, in a timely manner and with quality deliverables.
Supports the annual Qualified Health Plan (QHP) certification application and related activities for new and existing markets.
Leads project teams, involving staff from across the organization, to implement new standards/processes for which the Government Contracts department is accountable or otherwise involved.
Establishes internal tracking and reporting strategies for Marketplace Government Programs.
Manages applicable Marketplace Government Contracts policies and procedures to ensure they are current and up to date.
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.
Coordinates the execution of contracts, amendments and attestations of compliance.
Collaborates with department leaders for process improvements and to resolve issues effectively.
Assigns work to team based on priority, manages resources and communicates obstacles to leadership