Teams at Molina Healthcare Inc.

Leads complex, cross-functional business programs and strategic initiatives from planning through implementation and operational transition. Manages scope, schedules, budgets, resources, dependencies, risks, vendors, documentation, compliance, and stakeholder alignment. Partners with healthcare, clinical, operational, compliance, finance, network, and technology teams to translate business requirements into operational solutions and deliver enterprise-wide transformation initiatives.

Leads federal and state government affairs, policy advocacy, lobbying, legislative monitoring, regulatory strategy, and PAC contribution activities. Builds relationships with Congress, government agencies, state health plans, and other stakeholders; advises senior leadership; coordinates lobbyists; and may manage policy professionals. Requires extensive knowledge of Medicaid, Medicare, Marketplace programs, healthcare policy, ACA issues, state legislative processes, and government relations.

Reviews and resolves member and provider appeals, grievances, disputes, and claims reconsiderations. Researches medical records, claims, contracts, benefits, fee schedules, and payment errors to determine appropriate outcomes. Prepares compliant correspondence and appeal summaries, communicates decisions, documents findings, and meets regulatory and production timelines for Medicare, Medicaid, and other managed care programs.