高级专员，政府合同（必须居住在IL远程）
Sr Specialist, Government Contracts (Must Live in IL Remote)
Molina Healthcare of Illinois 正在招聘一位高级政府合同专员，工作地点为伊利诺伊州。该职位支持远程办公；但候选人必须居住在伊利诺伊州。
该职位负责支持医疗补助和 DSNP 的政府合同文件及监管要求的开发、审查、提交、实施和持续维护。该职位帮助确保符合州和联邦要求，这直接影响到会员获得服务的途径、供应商网络运营以及 Molina 成功管理政府项目的能力建立。
该专员职责包括协调监管交付物、监控合规要求、支持合同实施和州合同修订，并与其他部门合作以确保 Molina 履行合同义务。
为政府合同活动提供高级别支持。负责与州和/或联邦政府签订医疗补助、医疗保险、市场计划以及其他政府资助项目的合同，为指定 Molina 市场的低收入、无保险和其他人群提供医疗服务。
高度合格的候选人应具备以下经验：
- MCO 经验及解读合同条款的能力
- 相关政府医疗合同经验
- 项目管理能力
- 强大的分析能力，注重细节，优秀的书面沟通能力、组织能力，以及在高度监管环境中工作的经验
主要工作职责
• 支持政府合同活动，包括协调、开展和/或回应与政府医疗保健项目相关的研究请求，准备并提交监管报告进行备案，审查计划提交物的质量、准确性和及时性，并确保计划符合合同和监管要求。
• 在提交前审查供应商协议、保障证明（EOC）、会员手册、供应商目录、营销材料和其他合同报告交付物，确保其符合合同和监管要求。
• 评估来自政府合同机构和监管机构的信息，并传达给相关计划人员。
• 参与与州机构和 Molina 公司各部门有关 Molina 政府运行项目的会议，并将相关信息传达给员工和管理层。
• 负责/维护部门
查看英文原文
Molina Healthcare of Illinois is hiring a Sr. Specialist, Government Contracts in Illinois. This position is remote; however, candidates must reside in Illinois.
This role supports the development, review, submission, implementation, and ongoing maintenance of government contract documents and regulatory requirements across Medicaid and DSNP. The position helps ensure compliance with state and federal requirements, which directly impacts member access to services, provider network operations, and Molina's ability to successfully administer government programs.
The specialist role is responsible for coordinating regulatory deliverables, monitoring compliance requirements, supporting contract implementation and state contract amendments, and partnering across departments to ensure Molina meets contractual obligations.
Provides senior level support for government contracts activities. Responsible for the 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.
Highly Qualified Candidates Will Have the Following Experience:
- MCO experience and ability to interpret contract language
- Relevant government healthcare contracting experience
- Project management
- Strong analytical skills, attention to detail, excellent written communication, organization, and experience working in a highly regulated environment
Essential Job Duties
• Supports government contracts activities including coordinating, conducting and/or responding to research requests pertaining to government health care 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 agreements, evidence of coverage (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 leadership.
• 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.
• Conducts structured evidence reviews/audits of new regulatory mandates contract amendments and other operational implementations, and verifies that Molina business units have implemented required changes.
Required Qualifications
• At least 3 years of experience in Medicaid, Medicare, and/or Marketplace health insurance/government programs, and at least 1 year of experience in government contracts, or equivalent combination of relevant education and experience.
• Knowledge of Medicaid, Medicare, Marketplace and/or other government-sponsored programs and program compliance.
• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Detail oriented and analytical reasoning abilities.
• Proficient in analyzing and compiling data, creating reports, and presenting information.
• Ability to work cross-functionally in a highly matrixed environment.
• Effective verbal, written, and interpersonal communication skills, including ability to communicate and present to internal and external stakeholders.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Compliance-related experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Originally posted on Himalayas