Sr Specialist, Government Contracts (Medicaid) Must Live in FL

Molina Healthcare•Long Beach, FL

About The Position

Molina Healthcare of Florida is hiring a Senior Specialist in its Government Contracts department. Candidates must reside in Florida. The role provides senior-level support for government contract activities and supports the development and administration of contracts with state and federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored health care programs in designated Molina markets. The position supports research requests, regulatory reporting and filings, review of plan submissions, and compliance with contractual and regulatory requirements. It reviews provider agreements, evidence of coverage, member handbooks, provider directories, marketing materials, and other reporting deliverables before submission. The specialist also assesses information from government agencies and regulators, shares relevant updates with impacted staff, participates in meetings with state agencies and Molina departments, and maintains the department’s documentation and archive system for historical and audit purposes. The role conducts structured evidence reviews and audits of regulatory mandates, contract amendments, and operational implementations, and verifies that required changes have been implemented by Molina business units.

Requirements

Must reside in Florida.
At least 3 years of experience in Medicaid, Medicare, and/or Marketplace health insurance or government programs, and at least 1 year of experience in government contracts, or an 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, with the ability to manage simultaneous projects and tasks to meet internal deadlines.
Detail orientation and analytical reasoning abilities.
Proficiency 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 the ability to communicate and present to internal and external stakeholders.
Proficiency with Microsoft Office suite and applicable software programs.

Nice To Haves

Managed care experience, preferably involving Florida Medicaid and CMS contracting, regulatory, or compliance work.
Knowledge of CMS plans.
Compliance-related experience.

Responsibilities

Provide senior-level support for government contracts activities.
Support the development and administration of state and federal government contracts for Medicaid, Medicare, Marketplace, and other government-sponsored programs.
Coordinate, conduct, and respond to research requests concerning government health care programs.
Prepare and submit regulatory reports and filings.
Review plan submissions for quality, accuracy, and timeliness, and ensure plans meet contractual and regulatory requirements.
Review provider agreements, evidence of coverage, member handbooks, provider directories, marketing materials, and other contract reporting deliverables for compliance before submission.
Assess information from government contracting agencies and regulators and disseminate it to impacted plan staff.
Participate in meetings concerning Molina government programs with state agencies and Molina corporate departments, and share relevant information with staff and leadership.
Oversee and maintain the department’s documentation and archive system, ensuring reports are archived for historical and audit purposes and that the system is complete and up to date.
Conduct structured evidence reviews and audits of new regulatory mandates, contract amendments, and operational implementations.
Verify that Molina business units have implemented required changes.