Job Details

Job Description

JOB DESCRIPTION

Job Summary

Ideal candidates will have experience working with Washington State managed care programs. This position requires residency in the state of Washington.

Provides executive level strategy and leadership for team responsible for government contracts activities. Responsible for 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 executive strategy development, vision and direction for government contracts activities. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
• 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 health plan leadership with various advocacy efforts in support of plan business operations.
• Hires, onboards, trains, develops, mentors and performance manages reporting team of government contracts professionals and demonstrates accountability for team goals/deliverables.
• Provides leadership on emerging health care issues, new business implementation, and strategic planning for the health plan.
• Provides contracts and relationship management for state and federal partners (Medicaid, Medicare, insurance commission) 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 health plan leadership to expand managed care and other health plan business opportunities such as Medicare-Medicaid duals (MMP), seniors and persons with disabilities (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 SPDs, and influences the state's implementation of ACA provisions.
• Represents Molina with key industry groups such as the state's Association of Health Plans, America's Health Insurance Plans (AHIP), Medicaid Health Plans of America (MHPA), and National Association of Insurance Commissioners (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, Marketplace, and other government-sponsored health care 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 request for information (RFI) responses, as well as request for application (RFA) and request for proposal (RFP) bid efforts, in collaboration with the corporate development team.

Required Qualifications
• At least 12 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and 8 years of experience in government contracts, or equivalent combination of relevant education and experience.
• At least 7 years management/leadership experience.
• Deep knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance.
• Ability to work cross-functionally in a highly matrixed environment.
• Excellent interpersonal skills.
• Strong organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Analytical reasoning ability and detail orientation.
• Proficient in compiling data, creating reports, and presenting information.
• Excellent verbal and written communication skills, including ability to communicate and present to internal and external stakeholders.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Legal/compliance-related experience.
• Deep Medicaid-specific experience.
• Experience with state/federal government relations and relationship building with key governmental representatives.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

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