Lead Generalist, Medicare Administration
- Full-time
Job Summary
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services. Also responsible for operational compliance and adherence to federal regulations. Works collaboratively with business and operational units to ensure the Medicare and Dual Eligible operations are supported by effective, accurate and efficient business processes; benefits are accurately defined, communicated, and configured; all member communications are compliant and data exchanges and reports are accurate, timely and meet federal requirements.
Knowledge / Skills / Abilities
The lead demonstrates superior SME on health plan operations and Medicare and MMP program requirements, and is looked to within the department as a leader. Assist functional business owners identify and implement operational process improvements. Support Medicare-Medicaid plans on Medicare and MMP member retention, performance optimization, MMP reporting, and new member acquisition objectives. Support department leaders on wide-ranging assignments involving sales, compliance, analytics, strategy, and policy. Develop Medicare Advantage analytic reports.
Job Qualifications
Required Education : BA / BS degree or minimum equivalent employment experience of 7+ years in Health Care or related field required.
Required Experience : 7+ years of experience in the managed healthcare industry in a health plan or related field with MMP - Medicare-Medicaid plans. Must have strong, quantitative, analytical skills and ability.
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. Pay Range : $77,969 - $141,371 / ANNUAL
- Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
Create a job alert for this search
Administration • Omaha, NE, US
Locum Physician (MD / DO) - Cardiology - General / Other in Omaha, NE
Travel MRI Tech - $2,957 to $3,136 per week in North Platte, NE
Travel MRI Tech - $2,039 to $2,260 per week in Lincoln, NE
Physician (MD / DO) - Internal Medicine - General / Other - $321,000 to $380,000 per year in Missouri Valley, IA
Travel MRI Tech - $2,234 per week in Lincoln, NE
Travel MRI Tech - $2,368 per week in Omaha, NE
Telemedicine Physician
Travel MRI Tech - $2,173 per week in Omaha, NE
Travel MRI Tech - $2,284 per week in Omaha, NE
Travel MRI Tech - $2,057 to $2,245 per week in Omaha, NE
Travel MRI Tech - $1,777 to $2,043 per week in Omaha, NE
Travel MRI Tech - $3,096 per week in Omaha, NE
Travel Nuclear Medicine Tech - $2,763 to $2,942 per week in Omaha, NE
Travel MRI Tech - $2,620 to $2,928 per week in Omaha, NE
Travel MRI Tech - $2,043 to $2,196 per week in Omaha, NE
Travel MRI Tech - $1,944 per week in Omaha, NE
Travel MRI Tech - $2,414 per week in Lincoln, NE