Texas Medicaid Operations Specialist (Hybrid)

hcsc; Richardson (TX); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Health Care Service Corporation in Texas seeks an experienced operations professional to oversee Medicaid UM/CM processes with a strong data reporting and compliance focus. You will coordinate across departments to implement policies, resolve escalated inquiries, and monitor performance against UMCM and contract requirements in Texas.

You will work in a hybrid arrangement with 3 days in office and 2 remote, located in Richardson or Austin. Sponsorship is not available.

Qualifications

• Bachelor's degree in Business with 4 years' experience OR 8 years in health insurance operations.
• Experience in project development, implementation and execution skills.
• Experience interfacing with internal clients and operations personnel.
• Strong verbal and written communication; ability to represent Medicaid department at meetings.
• Experience with multiple projects and interacting with all levels of customers.
• Interpersonal, organizational and analytical skills; leadership capability.

Responsibilities

• Provide operational services, assistance, and program coordination for Medicaid UM/CM and related functions.
• Resolve complex escalated inquiries and collaborate on policy and process improvements.
• Support compliance, reporting, and system changes to meet Texas UM and contract requirements.

Skills

Project management

Communication skills

Analytical skills

Interpersonal skills

Leadership

Organizational skills

Education

Bachelor's degree in Business

Tools

Microsoft Excel

Power BI

Job description

Health Care Service Corporation in Texas seeks an experienced operations professional to oversee Medicaid UM/CM processes with a strong data reporting and compliance focus. You will coordinate across departments to implement policies, resolve escalated inquiries, and monitor performance against UMCM and contract requirements in Texas.

You will work in a hybrid arrangement with 3 days in office and 2 remote, located in Richardson or Austin. Sponsorship is not available.