Molina Healthcare
Specialist, Government Contracts (Remote in UT)
Molina Healthcare, New York, New York, United States
Job Title
Job Summary: 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. Knowledge/Skills/Abilities: Performs 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 departments in resolution process. Maintains log to ensure prompt and timely resolution. Conducts research on government program and state requirements as needed. Helps maintain 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 contract requirements. Job Qualifications: Required Education: High School diploma or equivalent Required Experience: 2+ years experience in a managed care environment, preferably in Medicaid environment. Knowledge of state Medicaid Policies and Programs. Required License, Certification, Association: N/A Preferred Education: Bachelor's Degree in Business Administration, Healthcare or related field. Preferred Experience: 2+ years compliance related experience. 1+ years in Medicare. Preferred License, Certification, Association: N/A
Job Summary: 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. Knowledge/Skills/Abilities: Performs 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 departments in resolution process. Maintains log to ensure prompt and timely resolution. Conducts research on government program and state requirements as needed. Helps maintain 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 contract requirements. Job Qualifications: Required Education: High School diploma or equivalent Required Experience: 2+ years experience in a managed care environment, preferably in Medicaid environment. Knowledge of state Medicaid Policies and Programs. Required License, Certification, Association: N/A Preferred Education: Bachelor's Degree in Business Administration, Healthcare or related field. Preferred Experience: 2+ years compliance related experience. 1+ years in Medicare. Preferred License, Certification, Association: N/A