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.
This is a remote position, but there will be occasional required meetings at the office in Columbia, SC.
KNOWLEDGE/SKILLS/ABILITIES
- Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements.
- Reviews Provider Agreement, 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 management.
- Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete.
JOB QUALIFICATIONS
Required Education
- High School diploma or equivalent
Required Experience
- 3 years’ experience in a managed care environment.
- Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills.
- Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel.
Preferred Education
- Bachelor's Degree in Business Administration, Healthcare, or related field.
Preferred Experience
- Experience working with a Medicaid program to include working with external regulators
- Experience working with and interpreting contracts
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.