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Sr Specialist, Govt Contracts (Must Reside in Columbia, SC)

  • Job
    Full-time
    Mid Level
  • Government & Politics
    Healthcare
  • Columbia, +1
    Remote

AI generated summary

  • You must have a diploma, 3 years in managed care, strong communication and analytical skills, proficiency in reporting tools, and experience with Medicaid programs and contracts.
  • You will coordinate research requests, prepare regulatory reports, review contracts for compliance, disseminate information, and maintain documentation for government healthcare programs.

Requirements

  • High School diploma or equivalent
  • 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.
  • Bachelor's Degree in Business Administration, Healthcare, or related field.
  • Experience working with a Medicaid program to include working with external regulators
  • Experience working with and interpreting contracts

Responsibilities

  • 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.

FAQs

Do we support remote work?

Yes, this position is remote but requires occasional in-office meetings in Columbia, SC.

Do we support Medicare?

Yes, we support Medicare as part of our government-sponsored programs.

What type of experience is required for this position?

The role requires 3 years of experience in a managed care environment.

Is a college degree required for this role?

A High School diploma or equivalent is required; however, a Bachelor's Degree in Business Administration, Healthcare, or a related field is preferred.

What skills are important for this position?

Important skills include strong communication and presentation abilities, analytical and reasoning skills, attention to detail, organization, and interpersonal skills.

What tools should I be proficient in for this job?

Proficiency in compiling data and creating reports using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel is required.

What responsibilities will I have in this role?

Responsibilities include coordinating research requests, preparing regulatory reports, reviewing contract submissions for compliance, disseminating information from government agencies, and maintaining documentation archives.

Is experience with Medicaid programs preferred?

Yes, experience working with a Medicaid program and interpreting contracts is preferred.

What is the pay range for this position?

The pay range for this position is $40,851.44 - $88,511.46 annually, with actual compensation varying based on location, experience, education, and skill level.

Who do I contact if I'm currently a Molina employee and want to apply?

Current Molina employees should apply through the intranet job listing to express their interest in this position.

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.