Remote Medicaid Ops Specialist III-Epic Utilization Review

Pyramid Consulting, Inc; Long Beach (CA); Remote; USD 41,328 - 61,992; Full time

Benefits offered by this job

Health insurance

401(k) plan

Paid sick leave

Job summary

A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various employee benefits including health insurance and a 401(k) plan.

Qualifications

• 1–2+ years healthcare operations experience, with 3–5 years ideal.
• Strong Medicaid / Medi-Cal background required.
• Experience with Epic EHR, Kaiser HealthConnect preferred.

Responsibilities

• Conduct Medicaid / Medi-Cal Chart Review.
• Perform comprehensive health chart and administrative chart reviews.
• Ensure documentation completeness and regulatory compliance.

Skills

Healthcare operations experience

Medicaid / Medi-Cal background

Epic EHR experience

Utilization Review exposure

Ability to work independently

Education

High School Diploma

Associate or Bachelor’s degree

Tools

Epic

Tapestry

Job description

A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various employee benefits including health insurance and a 401(k) plan.