Senior Specialist, Government Contracts (Remote in EST / CST)

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.

Coordinates, conducts, and / or responds to research requests pertaining to government healthcare programs; prepares and submits regulatory reports for filings; reviews Plan submissions for quality, accuracy, and timeliness; and ensures 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.