Specialist, Government Contracts (MA State Health Plan)

Molina Healthcare•Long Beach, MA

About The Position

Provides support for government contracts activities, including the development and administration of contracts with state and/or federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs. These programs provide health care services to low-income, uninsured, and other populations in designated Molina markets. The role supports regulatory and contract administration by maintaining correspondence, regulatory databases, filing calendars, and the government contracts SharePoint site; coordinating communications and submissions with government agencies; reviewing contracts and regulatory requirements; and helping maintain company policies and procedures. It also responds to agency inquiries, researches program and state requirements, supports training on government-contract requirements, and reviews implementation of regulatory mandates and contract amendments across Molina business units.

Requirements

At least 1 year of experience in a managed care environment, preferably in a government-sponsored Medicaid setting, or an equivalent combination of relevant education and experience.
Knowledge of Medicaid, Medicare, Marketplace, and/or other government-sponsored programs and program compliance.
Strong organizational and time-management skills, including the ability to manage simultaneous projects and tasks to meet internal deadlines.
Detail orientation and analytical reasoning abilities.
Ability to analyze and compile data, create reports, and present 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 and applicable software programs.

Nice To Haves

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

Responsibilities

Support government contracts activities, including maintaining state correspondence and regulatory databases, communicating deliverables and submissions between staff and government agencies, maintaining and reviewing policies and procedures, and reviewing contracts.
Maintain calendars and databases documenting regulatory filings, approvals of member materials, member and provider inquiries, and ad hoc regulatory requests.
Respond to government-agency inquiries about plan issues and requirements; coordinate resolution with applicable departments and maintain a log to support prompt, timely resolution.
Research government-specific programs and state requirements.
Help maintain the government contracts SharePoint site, storing regulatory correspondence, reports, and materials and ensuring staff can access the information.
Participate in reviewing contract and regulatory requirements.
Coordinate the maintenance, review, and dissemination of company policies and procedures.
Assist in developing and deploying training programs related to government-contract requirements.
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.