Director, Government Contracts (Medicaid/Medicare) - REMOTE in Mississippi

Molina Healthcare; Long Beach (CA); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a strategic leader to oversee government contracts related to healthcare services. This role involves managing compliance with Medicaid, Medicare, and Marketplace programs, ensuring regulatory adherence, and leading cross-departmental teams to implement new standards. The ideal candidate will have a strong background in managed care, contract management, and regulatory reporting. Join a forward-thinking organization that values innovation and dedication to improving healthcare access for underserved populations. This position offers a unique opportunity to make a significant impact in the healthcare sector.

Qualifications

• 3-5 years in managed care with supervisory experience.
• Knowledge of Medicaid and Medicare policies.

Responsibilities

• Manage State healthcare contracts and ensure compliance.
• Lead project teams to implement new standards and regulations.

Skills

Managed Care Experience

Contract Management

Compliance Knowledge

Regulatory Reporting

Project Management

Education

Bachelor's Degree in Related Field

Master's Degree in Business Administration or Healthcare

Job description

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 managing the plan's State healthcare contracts, reviewing and implementing new program requirements and ensuring the plan complies with all health plan contractual and regulatory reporting requirements.
• Serves as the Plan's lead for State healthcare program contractual and regulatory requirements, including performing the initial assessment and overseeing the implementation of all proposed and new contractual and regulatory standards, ensuring the Plan meets all filing requirements and ad hoc reporting requests, in a timely manner and with quality deliverables.
• Manages the plan's State and plan partner contract renewal activities
• Leads project teams involving staff from across the Plan to implement new standards for which the Government Contracts department is accountable or otherwise involved.
• Chairs committees and leads workgroups to carry out assigned responsibilities.
• Assesses proposed State laws and regulations to determine potential impact and provides written reports of findings to requesting Plan and or MHI corporate staff.
• Supervises department staff in meeting assigned goals and job duties.
• Develops department staff to serve as product line SMEs in order to research standards and clarify program requirements for requesting staff.
• Serves as a key liaison with State healthcare agencies and regulators.
• Coordinates Plan responses/reports to State healthcare agencies, regulators and partners regarding contractual and regulatory issues.
• Identifies potential new business and bid opportunities for the Plan.

Job Qualifications

Required Education
Bachelor's degree in related field or equivalent combination of education and experience.

Required Experience
• 3-5 years' experience in a managed care environment, with at least 2 years' supervisory or management experience.
• Knowledge of State Health Department mandated laws and rulings.
• Comprehensive knowledge of Medicaid, Medicare, and Marketplace policies and programs.

• Compliance experience - Medicaid & Medicare.
• Contract management experience.
  

Preferred Education
Master's degree - Business Administration, Healthcare or Compliance 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.