DATE: July 16, 2025
POSITION: Government Programs Liaison
DEPARTMENT: Operations
BASE RATE: $27.43 per hour, with potential for additional compensation based on qualifications
POSITION SUMMARY:
This position works closely with the Chief Operating Officer (COO) to bridge regulatory requirements with operational execution across UPHP’s Medicare and Medicaid lines of business. This position serves as the primary point of contact between UPHP and state and federal agencies and ensures proactive awareness and integration of program and regulatory changes. The liaison demonstrates understanding of business operations, Medicaid and Medicare regulations, and strategic initiatives and drives improvement in operational performance. The liaison uses critical thinking to determine the best approach to strategic assignments and ensuring tasks and duties are completed in accordance with established goals, objectives, and standards of the Upper Peninsula Health Plan.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Follows established UPHP policies and procedures, objectives, safety standards, and sensitivity to confidential information.
2. Serves as the primary liaison with Michigan Department of Health and Human Services (MDHHS), Centers for Medicare and Medicaid Services (CMS), and other regulatory entities for all Medicare and Medicaid programs, a contractually required administrative position.
3. Represents UPHP in government stakeholder calls, state workgroups, and interdepartmental planning. Keeps the COO informed of communications.
4. Coordinates and tracks deliverables required by MDHHS and/or CMS; respond to inquiries and requests made by CMS and/or MDHHS as appropriate.
5. Distributes and maintains materials from CMS, MDHHS, and advocacy groups as appropriate. Facilitates interdepartmental review of all major contract changes to ensure compliance. Collaborates with first tier, downstream, and related entities when necessary.
6. Leads or supports project teams with implementing new requirements or correcting gaps in operations.
7. Collaborates with internal stakeholders to troubleshoot and resolve operational issues affecting members, providers, or regulatory deliverables.
8. Undertakes special projects and assignments, chairs or participates on committees at the request of the COO, and facilitates interdepartmental project management as needed.
9. Reviews and demonstrates knowledge of National Committee for Quality Assurance (NCQA) structure and process measures and assists operations teams with NCQA evaluation activities.
10. Enhances professional growth and development through participation in education programs, current literature, in-service meetings, and workshops.
11. Maintains confidentiality of client data.
12. Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS:
Education:
Minimum:
Bachelor’s degree in a related field
Preferred:
Bachelor’s degree in public health, healthcare administration, health education, communications,
or business.
Experience:
Minimum:
Three (3) to five (5) years of experience in managed care operations, Medicaid, or healthcare
regulatory compliance.
Preferred:
Five (5) or more years of progressively responsible experience in managed care operations,
Medicaid and Medicare program administration, or healthcare regulatory compliance; direct
experience interfacing with state and federal agencies.
Required Skills:
Keyboarding proficiency
Working knowledge of MS Office (Word, Excel, and PowerPoint)
Excellent human relation and oral/written communication with advanced knowledge of vocabulary, spelling, proper grammar, and punctuation
Excellent organizational abilities with attention to detail
Proofreading, editing, and writing skills
Research and analytical skills
Ability to operate standard office equipment (photocopier/scanner, fax, etc.)
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
Physical Requirements:
[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:
Ability to enter and access information from a computer
Ability to access all areas of the UPHP offices
Occasionally lifts supplies/equipment
Prolonged periods of sitting
Manual dexterity
Working Conditions:
Works in office conditions, but occasional travel is required
Subject to many interruptions
Occasionally subjected to irregular hours and evening meetings
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