Jobs for People with MS: National MS Society

JOB DESCRIPTION

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

• Leads the day-to-day oversight and monitoring of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, duals (MMP) and Marketplace

• Acts as the lead internal contact for informational requests and contract research

• Leads daily government contracts activities to ensure contractual compliance with regulatory agencies for all lines of business (Medicaid, MMP and Marketplace)

• Secures timely submission of all required reports

• Works with the health plan's departments on state requirements and inquiries

• Ensures accuracy, timeliness and completion of ad hoc regulatory inquiries/requests, marketing material submissions, policies, and procedures, etc.

• Assists with audits in coordination with the compliance department

• Maintains and updates regulatory work plans, including state regulatory guidance documents and state rules

• Maintains consistent processes for all lines of business within the Government Contracts department

• Maintains calendar and databases documenting regulatory filings

• Coordinates with other departments in resolution process. Maintains log to ensure prompt and timely resolution

• Conducts research on government programs and state requirements as needed

• Maintains 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

• Leads the development and deployment of training programs related to government contract requirements

• Some travel may be required.

JOB QUALIFICATIONS

Required Education

Bachelor's degree or equivalent combination of education and experience

Required Experience

• Minimum of five (5) years’ experience in a managed care environment (including Medicare, Medicaid and other State governed plans)

• Minimum of four (4) years of health insurance experience

• Minimum of two (2) years of Government Contracts experience

• Knowledge of Medicare compliance requirements

Preferred Education

Bachelor's Degree in Business Administration, Healthcare or related field.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $49,430.25 - $107,098.87 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.