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 sub... more details
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
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.
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.
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