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.
Job Duties
Oversees the strategic development and administration of contracts with the State and/or Federal government for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low-income, uninsured, and other populations. Serves as lead for contract knowledge and assists Plan Presidents with various advocacy efforts in support of Plan business operations. Provides leadership on emerging health care issues, new business implementation, and strategic planning for the health plans. Provides contracts and relationship management for State and Federal partners (Medicaid, Medicare, Insurance) and key State elected officials (Governor’s Office, State legislators, and local government officials). Leads and supervises Regulatory Submissions and Filings. Represents Molina at State and local meetings including those with leadership of the respective Departments of Health Services, Department of Insurance, and other agencies. Develops strategies to advocate for best practices that demonstratively improve contract terms or facilitate business objectives. Leads efforts with Plan Presidents to expand managed care and other health plan business opportunities (such as duals, SPDs, Accountable Care Act (ACA) Marketplace participation, and accountable care organization (ACO) delivery models). Improves coordination/integration of acute and long-term services and supports (LTSS) for dual eligible and seniors and persons with disabilities (SPDs), and influences the State’s implementation of the ACA provisions. Represents Molina with key industry groups such as the state's Association of Health Plans, AHIP, Medicaid Health Plans of America (MHPA), and NAIC. Also works with key advocacy groups and provider trade associations to advocate Molina’s position and business objectives and develop strategic partnerships. Works with Legal Affairs to assess and provide analyses for proposed changes to Medicaid, Medicare, Exchange, and other government-sponsored healthcare program contracts, governing regulations and new legislation and policy requirements. Oversees and monitors the implementation of new Medicaid and Medicare contractual and policy requirements, new legislation and regulations. Coordinates RFI responses, as well as RFA and RFP bid efforts, in collaboration with MHI Corporate Development.
Job Qualifications
REQUIRED EDUCATION:
Bachelor’s Degree in related field or equivalent combination of education and experience.
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
10+ years experience in government programs and 2+ years management experience. Extensive knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs.PREFERRED EDUCATION:
J.D. or a Masters Degree in Public Health, Public Policy or Business Administration.
PREFERRED EXPERIENCE:
Experience working in the managed care industry, particularly with health plans that contract with government-sponsored programs .
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.