Lead, Government Contracts - Must Reside in Columbia, SC

Job Description

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.