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 the administration of contracts with the State and/or Federal government for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low-income, uninsured, and other populations.
Serves as lead for contract knowledge and assists Plan President with various advocacy efforts in support of Plan business operations.
Provides contracts and relationship management for State and Federal partners (Medicaid, Medicare, Insurance) and key State elected officials (Governor's Office, State legislators, and/or local government officials).
Supervises Regulatory Submissions and Filings.
Represents Molina at State and local meetings including those with the Medicaid Director, Director of Insurance, and other Medicaid officials. Develops strategies to advocate for best practices that demonstratively improve contract terms or facilitate business objectives.
Identifies opportunities for strategic conversations with key stakeholders aligned with business needs (e.g., regarding duals, ABD children, and accountable care organizations (ACO's) that promote Molina approaches.
Improves coordination/integration of acute and long-term services and supports (LTSS) for dual eligible and influences the State's implementation of the ACA provisions.
Works with key statewide advocacy groups and provider trade associations to advocate Molina's position and business objectives and develop strategic partnerships.
Works with Legal Affairs to assess and provide analyses for proposed changes to Medicaid, Medicare, Exchange, and other government-sponsored healthcare program contracts, governing regulations and new legislation and policy requirements.
Oversees and monitors the implementation of new Medicaid and Medicare contractual and policy requirements, new legislation, and regulations.
Coordinates plan's RFI responses, as well as RFA and RFP bid efforts, in collaboration with MHI Corporate Development.
Coordinates with Director, Compliance on initiatives to improve adherence to plan policies and procedures and represents Government Contracts on Compliance Committee.
Coordinates the establishment of and maintains MOUs for the plan's carved-out and linked services in State healthcare programs as applicable.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in related field or equivalent combination of education and experience.
Required Experience
5 years' experience in government programs and at least 2 years supervisory/management experience.
Extensive knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs.
Preferred Education
Bachelor's or master's degree in public health, Public Policy or Business Administration.
Preferred Experience
Experience working in the managed care industry, particularly with health plans that contract with government-sponsored programs.
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: $122,430.44 - $238,739.35 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
