Federal government [h1.location_city]

Job Title

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.

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.

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.

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