Specialist, Government Contracts (EST business hours)

Molina Healthcare•Long Beach, CA

About The Position

Provides 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. Supports government contracts activities including maintenance of state correspondence and regulatory databases, communication of deliverables/submission between staff and governmental agencies, policy and procedure maintenance and review, and contract review. Maintains calendar and databases documenting regulatory filings, approvals of member materials, member/provider inquires and ad hoc regulatory requests. Responds to inquiries from government agencies regarding plan issues and requirements coordinates with other applicable departments in resolution process and maintains log to ensure prompt and timely resolution. Conducts research on government-specific programs and state requirements. Assists in maintenance of government contracts SharePoint site to store regulatory correspondence/reports/materials and ensure accessibility of information to staff. Participates in review of contract and regulatory requirements. Coordinates the maintenance, review, and dissemination of company policies and procedures. Assists in development and deployment of training programs related to government contracts requirements. Conducts structured evidence reviews/audits of new regulatory mandates contract amendments and other operational implementations, and verifies that Molina business units have implemented required changes.

Requirements

At least 1 year of experience in a managed care environment - preferably in a government sponsored Medicaid setting, or 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, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Detail oriented and analytical reasoning abilities.
Proficient 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 ability to communicate and present to internal and external stakeholders.
Microsoft Office suite and applicable software programs proficiency.

Nice To Haves

Medicaid, Medicare, and/or Marketplace government programs experience.
Compliance-related experience.

Responsibilities

Supports government contracts activities including maintenance of state correspondence and regulatory databases, communication of deliverables/submission between staff and governmental agencies, policy and procedure maintenance and review, and contract review.
Maintains calendar and databases documenting regulatory filings, approvals of member materials, member/provider inquires and ad hoc regulatory requests.
Responds to inquiries from government agencies regarding plan issues and requirements coordinates with other applicable departments in resolution process and maintains log to ensure prompt and timely resolution.
Conducts research on government-specific programs and state requirements.
Assists in maintenance of government contracts SharePoint site to store regulatory correspondence/reports/materials and ensure accessibility of information to staff.
Participates in review of contract and regulatory requirements.
Coordinates the maintenance, review, and dissemination of company policies and procedures.
Assists in development and deployment of training programs related to government contracts requirements.
Conducts structured evidence reviews/audits of new regulatory mandates contract amendments and other operational implementations, and verifies that Molina business units have implemented required changes.