Specialist, Regulatory Project Management

Found in: Jooble US O C2 - 2 weeks ago

Reno NV, United States Molina Healthcare Full time

Molina Healthcare of Nevada is hiring for a Managed Care, Gov Contracts Sr. This role can be worked remotely from anywhere in the state of Nevada..
This position works with state regulators to exceed requirements and performance expectations in the execution of the company’s Medicaid contract. Reading, interpreting, and responding to Managed Care regulatory bodies and contracts. 
Project Management experience in healthcare with the ability to communicate confidently and reliably. Experience in compliance, quality, accreditation, government affairs/lobbying a plus.
Experience reading, understanding, following state/federal contracts, rules, policy and law.
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.
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.
Bachelor's Degree in Business Administration, Healthcare, or related field. 3 years’ experience in a managed care environment.
~ Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel.

Project Management experience in healthcare with the ability to communicate confidently and reliably. Experience in compliance, quality, accreditation, government affairs/lobbying a plus.
Experience reading, understanding, following state/federal rules, policy and law.
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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