Job Description

Job Description

Job Summary

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Commercial, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.

Knowledge/Skills/Abilities

Responsible for day-to-day oversight, monitoring, and management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, duals (MMP) and Marketplace.
Serves as primary internal contact for informational requests and contract interpretations.
Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business (Medicaid, MMP and Marketplace) and ensures timely submission of all required reporting.
Works with functional area owners on state requirements and deliverables to ensure accuracy, timeliness and completion (e.g. regarding required submissions, member and provider inquiries, ad hoc regulatory inquiries/requests, marketing material submissions, changes to contract requirements, and scorecards for state inquiries, submissions and deliverables).
Develops responses to state agencies as required for MyCare, Medicaid and Marketplace product lines and coordinates filing process for the Marketplace line of business.
Develops, maintains and updates regulatory work plans, including state regulatory guidance documents and state rules. Educates internal staff on changes to regulatory contracts.
Develops and maintains consistent processes for all lines of business within the Government Contracts department.

Required Education

High School diploma or equivalent

Required Experience

Min. 3 years' experience in a managed care environment, State Governed Plans, or Commercial.
MS Office, Excel, Word, and SharePoint.

Preferred Education

Bachelor's degree in Business Administration, Healthcare or related field.

Preferred Experience

Commercial, Marketplace and or Regulatory experience in any healthcare environment.

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.

Qualifications

High School diploma or equivalent
3 years' experience in a managed care environment, State Governed Plans, or Commercial
MS Office, Excel, Word, and SharePoint
Bachelor's degree in Business Administration, Healthcare or related field
Commercial, Marketplace and or Regulatory experience in any healthcare environment

Responsibilities

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Commercial, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations
Responsible for day-to-day oversight, monitoring, and management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, duals (MMP) and Marketplace
Serves as primary internal contact for informational requests and contract interpretations
Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business (Medicaid, MMP and Marketplace) and ensures timely submission of all required reporting
Works with functional area owners on state requirements and deliverables to ensure accuracy, timeliness and completion (e.g. regarding required submissions, member and provider inquiries, ad hoc regulatory inquiries/requests, marketing material submissions, changes to contract requirements, and scorecards for state inquiries, submissions and deliverables)
Develops responses to state agencies as required for MyCare, Medicaid and Marketplace product lines and coordinates filing process for the Marketplace line of business
Develops, maintains and updates regulatory work plans, including state regulatory guidance documents and state rules
Educates internal staff on changes to regulatory contracts
Develops and maintains consistent processes for all lines of business within the Government Contracts department

Manager, Government Contracts (Marketplace) - REMOTE

Job Type