Specialist, Government Contracts (MA State Health Plan)

Molina Healthcare•Long Beach, CA

About The Position

Provides senior-level support for government regulatory contracts activities. The role supports the development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs that provide health care services to low-income, uninsured, and other populations in designated Molina markets.

Requirements

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.
Attention to detail 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 the Microsoft Office suite and applicable software programs.

Nice To Haves

Compliance-related experience.
Regulatory and compliance background.
SharePoint experience.

Responsibilities

Support regulatory government contract activities, including coordinating, conducting, and responding to research requests about government health care programs; preparing and submitting regulatory reports and filings; auditing and reviewing plan submissions for quality, accuracy, and timeliness; and ensuring the plan meets contractual and regulatory requirements.
Review provider agreements, evidence of coverage (EOC), 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 about Molina government-run 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 submitted 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 other operational implementations, and verify that Molina business units have implemented required changes.