Job Description JOB DESCRIPTION Job Summary
Responsible for the Management of the Molina Healthcare Washington Tribal Affairs program. Oversees all projects and responsibilities associated with supporting access to culturally responsive care; resources and services for Indigenous members; engaging and supporting the needs of Indian Health Care Providers (IHCPs); and supporting and developing collaborative relationships with Tribal Health Partners. Oversees cross-functional teams to ensure compliance with all state and federal requirements applying to Indian Health Care Providers (IHCPs), including, but not limited to:
Tribal billing and claims. Coordination with IHCPs on treatment and discharge planning, transition of care, continuity of care, referrals to culturally responsive and appropriate providers. Network contracting efforts. Planned collaboration related to any outreach, quality, or health equity.
Develops and supports the implementation of services, resources and programs that support the unique needs of a diverse network and membership. Extensive working knowledge of federal Managed Care Protections for Indian individuals and Indian health care providers. Responsible for overall compliance of any current or future contract expectations related to IHCPs, Tribes, or Tribal members enrolled in any Molina product; strong management and leadership skills; should be well experienced and comfortable working with Tribal leaders, government agencies, Tribal communities and IHCPs.
KNOWLEDGE/SKILLS/ABILITIES Manages programs using staff and matrixed resources with oversight from Director, AVP and VP as needed. Serves as industry Subject Matter Expert in the functional area and leads programs to meet critical needs. Escalates gaps and barriers in implementation and compliance to AVP, VP and senior management. Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy. Collaborates and facilitates internal and cross-market activities within Molina and including external partners. JOB QUALIFICATIONS Required Education
Bachelor's degree or equivalent combination of education and experience.
Required Experience
7-9 years of experience.
Preferred Education
Graduate Degree or equivalent combination of education and experience
Preferred Experience
10+ years of experience.
Managed Care industry experience - Medicaid / Medicare.
Tribal healthcare / programs experience.
Operations experience.
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.