Government Program Network Engagement Specialist - MD Live - Remote

3M HEALTHCARE; Deutschland; Remote; EUR 58.395 - 97.325; Vollzeit

Benefits dieser Stelle

Annual bonus plan

Comprehensive benefits package

Paid time off (minimum 18 days)

Zusammenfassung

The Cigna Group is seeking a Government Program Network Engagement Specialist to own Medicaid enrollment and regulatory relationships across assigned states. You will serve as the primary liaison to state Medicaid agencies and MCOs, ensuring providers are enrolled, linked, and compliant with state requirements.

In this role you will track, report, and optimize enrollment performance, engage regulators, and partner with Credentialing and Network Recruiting to support enrollment strategy and

Qualifikationen

• 4+ years of direct experience with Medicaid provider enrollment, government programs, or payer operations.
• Demonstrated deep knowledge of state Medicaid regulatory and enrollment processes.
• Proven experience working directly with state agencies, Medicaid MCOs, or government payers.
• Strong provider-facing communication skills with the ability to explain complex regulations clearly.
• High confidence interacting with regulators, providers, and executive stakeholders.
• Advanced analytical skills with experience tracking metrics, building reports, and identifying trends.

Aufgaben

• Serve as primary point of contact for assigned state Medicaid agencies, Medicaid MCOs, and providers.
• Maintain expert-level knowledge of state Medicaid enrollment, revalidation, linking, and termination requirements.
• Own end-to-end Medicaid enrollment and linking outcomes for an assigned group of states.
• Proactively manage regulatory changes, renewals, audits, and revalidations to ensure uninterrupted provider participation.
• Ensure providers are enrolled, linked, billable, and compliant within required state timelines.
• Actively prevent enrollment lapses and terminations through tracking, outreach, and proactive revalidation management.
• Build and maintain trusted relationships with state regulators and payer partners to resolve enrollment issues and escalations.
• Engage directly with providers to explain Medicaid requirements, enrollment status, timelines, and next steps.
• Translate regulatory requirements into clear, actionable guidance for providers and internal stakeholders.
• Represent the voice of the provider in Medicaid workflows, process improvements, and issue resolution.
• Partner closely with Network Recruiters to support hiring priorities aligned to state Medicaid needs.
• Collaborate with Credentialing on applications, verifications, renewals, linking, and data accuracy.
• Work cross-functionally with Operations, Finance, and Leadership to resolve enrollment blockers impacting access or revenue.
• Support development and refinement of standard operating procedures across government programs.
• Track, analyse, and report Medicaid enrollment metrics by state, provider, and timeline.
• Develop executive-ready reporting on performance, risks, trends, compliance, and continuity of enrollment.
• Use data and analysis to identify gaps, improve enrollment speed, inform strategy, and support leadership decision-making.
• Measure success by number of enrolled and linked providers, timeliness and accuracy, reduced lapses, provider satisfaction, reporting quality, and strength of state and MCO relationships.

Kenntnisse

Medicaid enrollment

Stakeholder communication

Regulatory compliance

Data analysis

Excel dashboards

Relationship management

Ausbildung

Bachelor’s degree in Healthcare Administration, Public Policy or Business

Tools

Dashboards & reporting tools (Tableau/Power BI)

Jobbeschreibung

Job Overview

The Government Program Network Engagement Specialist is a highly specialized role responsible for owning MDLIVE’s Medicaid provider enrollment and regulatory relationships across an assigned cohort of states. This role serves as the primary liaison to state Medicaid agencies and managed care organizations (MCOs), ensuring providers are fully enrolled, linked, and remain continuously compliant with state‑specific Medicaid requirements. This individual partners closely with Network Recruiting and Credentialing to operationalize enrollment strategy, minimise risk of enrollment lapses, and ensure provider availability aligns with business growth goals. Success in this role requires the ability to gain/maintain deep Medicaid regulatory knowledge, strong provider‑facing communication skills, comfort engaging with regulators, and advanced analytical capabilities to track, report, and improve performance.

Key Responsibilities

• Serve as primary point of contact for assigned state Medicaid agencies, Medicaid MCOs, and providers.
• Maintain expert‑level knowledge of state‑specific Medicaid enrollment, revalidation, linking, and termination requirements.
• Own end‑to‑end Medicaid enrollment and linking outcomes for an assigned group of states.
• Proactively manage regulatory changes, renewals, audits, and revalidations to ensure uninterrupted provider participation.
• Ensure providers are enrolled, linked, billable, and compliant within required state timelines.
• Actively prevent enrollment lapses and terminations through tracking, outreach, and proactive revalidation management.
• Build and maintain trusted relationships with state regulators and payer partners to resolve enrollment issues and escalations.
• Engage directly with providers to explain Medicaid requirements, enrollment status, timelines, and next steps.
• Translate regulatory requirements into clear, actionable guidance for providers and internal stakeholders.
• Represent the voice of the provider in Medicaid workflows, process improvements, and issue resolution.
• Partner closely with Network Recruiters to support hiring priorities aligned to state Medicaid needs.
• Collaborate with Credentialing on applications, verifications, renewals, linking, and data accuracy.
• Work cross‑functionally with Operations, Finance, and Leadership to resolve enrollment blockers impacting access or revenue.
• Support development and refinement of standard operating procedures across government programs.
• Track, analyse, and report Medicaid enrollment metrics by state, provider, and timeline.
• Develop executive‑ready reporting on performance, risks, trends, compliance, and continuity of enrollment.
• Use data and analysis to identify gaps, improve enrollment speed, inform strategy, and support leadership decision‑making.
• Measure success by number of enrolled and linked providers, timeliness and accuracy, reduced lapses, provider satisfaction, reporting quality, and strength of state and MCO relationships.

Required Qualifications

• High school diploma or GED required.
• 4+ years of direct experience with Medicaid provider enrollment, government programs, or payer operations.
• Demonstrated deep knowledge of state Medicaid regulatory and enrollment processes.
• Proven experience working directly with state agencies, Medicaid MCOs, or government payers.
• Strong provider‑facing communication skills with the ability to explain complex regulations clearly.
• High confidence interacting with regulators, providers, and executive stakeholders.
• Advanced analytical skills with experience tracking metrics, building reports, and identifying trends.
• Strong Excel skills (pivot tables, formulas, data analysis); experience with dashboards and reporting tools preferred.
• Exceptional organisational skills with the ability to manage multiple states, timelines, and priorities.
• Familiarity with credentialing systems, payer enrollment platforms, and provider data management.
• Experience presenting data and progress updates to senior leadership.
• Background in process improvement, compliance, or risk mitigation within healthcare operations.

Preferred Qualifications

• Bachelor’s degree in Healthcare Administration, Public Policy or Business.
• Experience with dashboards and reporting tools.

Compensation and Benefits

Annual salary range: $66,600 – $111,000 USD, dependent on experience and geographic location.

Eligible to participate in an annual bonus plan.

Benefits include medical, vision, dental, well‑being and behavioural health programs; 401(k); company‑paid life insurance; tuition reimbursement; a minimum of 18 days of paid time off per year and paid holidays.

Work Conditions

Partially or fully remote work is possible. Remote employees must have a stable internet connection provided by a cable broadband or fibre‑optic service with a minimum of 10Mbps download/5Mbps upload.

EEO and Accommodation Statement

Qualified applicants will be considered without regard to race, colour, age, disability, sex, childbirth (including pregnancy), sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. This inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco‑free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Mandatory smoking‑cessation program participation is required for employment in those states.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state, and local ordinances.