Medicaid Claims Operations Leader — Hybrid & Impactful

General Dynamics Information Technology, Inc.; Montgomery (AL); Hybrid; USD 111,000 - 150,000; Full time

Benefits offered by this job

Health plan options

401K with company match

Paid time off

Full flex work weeks

Job summary

General Dynamics Information Technology (GDIT) is seeking a Claims Operations Manager to lead the day-to-day Medicaid Enterprise System claims processing under the Fiscal Agent Operations function in Montgomery, AL. You will supervise staff, ensure SLA adherence, and optimize processing, adjudication, and resolution of Medicaid claims for beneficiaries.

The role requires a Bachelor's degree and 8 years of Medicaid or health payer claims experience, with strong leadership, stakeholder engagement,

Qualifications

• Bachelor's Degree in related technical, scientific, business, health or related discipline (or equivalent work experience).
• Eight (8) years of experience managing Medicaid or Major Health Care Payer Claims processing.
• Medicaid operations leadership and staff management abilities.
• Strong communication of issues, impacts, and corrective actions.

Responsibilities

• Manage day-to-day MES claims operations with staff and supervisors to ensure timely, accurate processing and adjudication of Medicaid claims.
• Lead cross-departmental efforts, optimize resources, and ensure SLA delivery.
• Serve as primary CMS/state customer contact and oversee all claims processing, including resolution, drug rebate, medical policy, and data entry.
• Drive change management and reporting to optimize SLAs and resource usage.
• Communicate with internal/external stakeholders and support audits and quality assessments.

Skills

Medicaid operations leadership

Staff leadership

Stakeholder engagement

Communication

Education

Bachelor's degree in related field

Tools

SharePoint

Excel

PMO

PowerPoint

Job description

General Dynamics Information Technology (GDIT) is seeking a Claims Operations Manager to lead the day-to-day Medicaid Enterprise System claims processing under the Fiscal Agent Operations function in Montgomery, AL. You will supervise staff, ensure SLA adherence, and optimize processing, adjudication, and resolution of Medicaid claims for beneficiaries.

The role requires a Bachelor's degree and 8 years of Medicaid or health payer claims experience, with strong leadership, stakeholder engagement,