Senior Government Contracts Specialist (Remote - Must Reside in Arizona)

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 :

Responsible for coordinating, conducting and / or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements.

Reviews Provider Agreement, EOC / Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission.

Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff.

Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management.

Oversees / maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete.

Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and / or direction to internal staff.

Serve as liaison between the department and the organization's business owners / leaders and its staff members.

Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness.

Support business owners in the preparation of the AHCCCS triannual Operational Review.

Assist in project managing contract implementation, amendments, and state policy changes.

Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current.

Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency.

Other duties as assigned.

Job Qualifications :

Required Education : High School diploma or equivalent

Required Experience :

3 years' experience in a managed care environment.

Experience demonstrating strong : communication and presentation skills; analytical / reasoning ability; detail orientation; organizational and interpersonal skills.

Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel.

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 : $45,390 - $88,511.46 / ANNUAL

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