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Molina Healthcare

Runs health plans for government programs

Government Contracts Specialist - Government Contracts, MA State Health Plan

Regulatory Compliance & EthicsConfirmed live in the last 24 hours
Contract$20.74 - $40.44 /hrIn-person

About the Job

Requirements

  • At least 1 year of experience in a managed care environment, preferably in a government-sponsored Medicaid setting, or an equivalent combination of relevant education and experience.
  • Knowledge of Medicaid, Medicare, Marketplace, and/or other government-sponsored programs and program compliance.
  • Organizational and time-management skills, with the ability to manage simultaneous projects and tasks to meet internal deadlines.
  • Detail orientation and analytical reasoning abilities.
  • Proficiency in analyzing and compiling data, creating reports, and presenting information.
  • Ability to work cross-functionally in a highly matrixed environment.
  • Effective verbal, written, and interpersonal communication skills, including the ability to communicate and present to internal and external stakeholders.
  • Proficiency with Microsoft Office suite and applicable software programs.

Responsibilities

  • Support government contracts activities, including maintaining state correspondence and regulatory databases, communicating deliverables and submissions between staff and governmental agencies, maintaining and reviewing policies and procedures, and reviewing contracts.
  • Maintain calendars and databases documenting regulatory filings, approvals of member materials, member and provider inquiries, and ad hoc regulatory requests.
  • Respond to government agency inquiries regarding plan issues and requirements, coordinate resolution with applicable departments, and maintain a log to ensure prompt and timely resolution.
  • Research government-specific programs and state requirements.
  • Assist in maintaining the government contracts SharePoint site to store regulatory correspondence, reports, and materials and ensure staff can access the information.
  • Participate in reviewing contract and regulatory requirements.
  • Coordinate the maintenance, review, and dissemination of company policies and procedures.
  • Assist in developing and deploying training programs related to government contracts requirements.
  • Conduct structured evidence reviews and audits of new regulatory mandates, contract amendments, and other operational implementations, and verify that Molina business units have implemented required changes.

Desired Qualifications

  • Experience with Medicaid, Medicare, and/or Marketplace government programs.
  • Compliance-related experience.

About the Company

Molina Healthcare

Runs health plans for government programs

Molina Healthcare runs health insurance plans for people covered by Medicaid, Medicare and state insurance marketplaces, with a focus on people who need affordable access to care. Its local health plans coordinate medical services and support members with complex health needs, including people eligible for both Medicaid and Medicare. Members receive care through networks of doctors, hospitals and other providers, while the plans manage benefits, process claims and arrange care support. The company earns premiums from government programs and members, and pays the cost of covered healthcare services. Molina was founded in 1980 and is headquartered in Long Beach, California.

Company size
10,001+
Company stage
IPO
Headquarters
Long Beach, CA
Founded
1980

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