Medicaid Programs Coordinator II - SoonerCare & Coverage

Oklahoma AG; Oklahoma City (OK); On-site; USD 64,747,000 - 68,880,000; Full time

Benefits offered by this job

State-paid benefit allowance

Retirement Savings Plan with employer

11 paid holidays

Vacation and sick leave

Job summary

The Oklahoma Health Care Authority (OHCA) is seeking an ECS Coordinator II / IO Program Coordinator II / Provider Representative II to support SoonerCare and other Medicaid programs. The role focuses on resolving member and provider inquiries, processing claims, managing enrollments, and ensuring compliance with program policies while delivering high-quality service.

Responsibilities include researching inquiries, addressing access to care issues, communicating policy guidelines, and

Qualifications

• In-depth knowledge of Medicaid program policies.
• Strong communication skills for resolving inquiries.
• Ability to manage complex administrative processes.

Responsibilities

• Research and resolve provider and member inquiries and denied claims.
• Investigate access to care issues, fraud, abuse, and quality assurance concerns.
• Interpret and communicate SoonerCare policies to providers and members.
• Manage member applications, enrollments, plan changes, and eligibility verifications.
• Coordinate with other departments on referral issues and operational procedures.

Job description

The Oklahoma Health Care Authority (OHCA) is seeking an ECS Coordinator II / IO Program Coordinator II / Provider Representative II to support SoonerCare and other Medicaid programs. The role focuses on resolving member and provider inquiries, processing claims, managing enrollments, and ensuring compliance with program policies while delivering high-quality service.

Responsibilities include researching inquiries, addressing access to care issues, communicating policy guidelines, and