Specialist, Government Contracts (MA State Health Plan)

Molina Healthcare; Boston (MA); Vor Ort; USD 29.000 - 56.000; Vollzeit

Zusammenfassung

Molina Healthcare in Boston is seeking a senior government contracts specialist to develop and administer contracts with state and federal government programs, including Medicaid, Medicare, and Marketplace, ensuring services reach eligible populations.

The role involves coordinating regulatory research, submitting reports and audits, reviewing contracts for compliance, and collaborating with state agencies and Molina teams to implement required changes, while maintaining thorough documentation.

Qualifikationen

• 3+ years in Medicaid/Medicare/Marketplace programs.
• 1+ year in government contracts or equivalent.
• Knowledge of Medicaid/Medicare programs and compliance.
• Strong organizational and time-management skills.
• Detail oriented with analytical reasoning.
• Proficient in data analysis, reporting and presentation.
• Ability to work cross-functionally in a matrixed environment.
• Effective verbal, written, and interpersonal communication.

Aufgaben

• Supports regulatory government contracts activities including coordinating, conducting and/or responding to research requests.
• Prepares and submits regulatory reports, audits, and plan submissions for quality and timeliness.
• Reviews provider agreements, EOC, member handbook, provider directory, marketing materials for compliance.
• Assesses information from government agencies and disseminates to impacted staff.
• Participates in meetings with state agencies and Molina departments and shares updates.
• Maintains documentation and archive system for reports and audits.
• Conducts structured evidence reviews of new mandates and contract amendments; verifies implementation.

Kenntnisse

Medicaid experience

Medicare experience

Marketplace experience

Regulatory compliance

Analytical thinking

Data analysis

Report writing

Cross-functional collaboration

Time management

Communication skills

Tools

Microsoft Office

SharePoint

Jobbeschreibung

JOB DESCRIPTION

Provides senior level support for government regulatory contracts activities. Responsible for the 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 in designated Molina markets.

Job Summary

Provides senior level support for government regulatory contracts activities. Responsible for the 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 in designated Molina markets.

Essential Job Duties

• Supports regulatory government contracts activities including coordinating, conducting and/or responding to research requests pertaining to government health care programs, preparing and submitting regulatory reports for filings, audiring, reviewing plan submissions for quality, accuracy and timeliness, and ensuring plan meets contractual and regulatory requirements.


• Reviews provider agreements, evidence of coverage (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 leadership.


• Oversees/maintains the department’s documentation and archive system - ensuring submitted reports are archived for historical and audit purposes; ensuring system is updated and complete.


• Conducts structured evidence reviews/audits of new regulatory mandates contract amendments and other operational implementations, and verifies that Molina business units have implemented required changes.

Required Qualifications

• At least 3 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and at least 1 year of experience in government contracts, or equivalent combination of relevant education and experience.


• Knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance.


• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.


• Detail oriented and analytical reasoning abilities.


• Proficient in analyzing and compiling data, creating reports, and presenting information.


• Ability to work cross-functionally in a highly matrixed environment.


• Effective verbal, written, and interpersonal communication skills, including ability to communicate and present to internal and external stakeholders.


• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Compliance-related experience.


• Regulatory and Compliance background


• Sharepoint experience

Molina offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $20.74 - $40.44 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.