Senior Specialist, Government Contracts

Molina Healthcare

130d • $47,660 - $88,511 • Remote

About The Position

Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in Illinois. The Sr Specialist in our Government Contracts will be responsible for the strategic 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. You will also Intake state correspondence for Government Contract SharePoint logs, assign internally, and track to completion. Provide timely responses to external regulators on all requests. Attend and take notes for HFS meetings. Track Member/Provider complaints along with the impact on customer experience with Molina to improve on all levels.

Requirements

• High School diploma or equivalent required.
• 3 years' experience in a managed care environment required.
• Strong communication and presentation skills.
• Analytical/reasoning ability and detail orientation.
• Organizational and interpersonal skills.
• Proficient in compiling data, creating reports, and presenting information using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel.

Nice To Haves

• Bachelor's Degree in Business Administration, Healthcare, or related field preferred.
• Familiarity with Managed Care in Illinois and how HHF operates.
• Background/experience in business analytics, deadline tracking, and previous experience researching and interpreting contract language.

Responsibilities

• Strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs.
• Intake state correspondence for Government Contract SharePoint logs, assign internally, and track to completion.
• Provide timely responses to external regulators on all requests.
• Attend and take notes for HFS meetings.
• Track Member/Provider complaints and their impact on customer experience with Molina.
• Coordinate, conduct and/or respond to research requests pertaining to government healthcare programs.
• Prepare and submit regulatory reports for filings.
• Review Plan submissions for quality, accuracy, and timeliness.
• Ensure Plan meets contractual and regulatory requirements.
• Review Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance.
• Assess information received from government contracting agencies and regulators and disseminate to impacted Plan staff.
• Participate in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminate relevant information to staff and management.
• Oversee/maintain the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED