Senior Specialist, Government Contracts

Molina Healthcare•Long Beach, FL

About The Position

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.

Requirements

At least 3 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and 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.
Ability to work cross-functionally in a highly matrixed environment.
Effective interpersonal skills.
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 analyzing and compiling data, creating reports, and presenting information.
Effective 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

Compliance-related experience.

Responsibilities

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.