Texas Medicaid Operations Specialist - Hybrid Richardson, TX

About the role

This position is responsible for providing operational services, assistance, and program implementation and coordination for day-to-day Texas Medicaid reporting, contract compliance, and operational functions.

Responsibilities

• Supports Texas Medicaid Operations by managing communications, deliverables, and reporting commitments with the State of Texas in accordance with BCBSTX's STAR, CHIP, and STAR Kids contracts.
• Serves as a primary communication hub between the State and internal stakeholders, ensuring regulatory requirements and contractual obligations are met.
• Resolves complex and/or escalated internal and external operational questions, coordinates deliverables across business areas, and partners with internal stakeholders on the development, testing, and implementation of program policies, business processes, reporting solutions, and system changes to ensure state requirements are met.
• Supports special projects, analyzes and performs quality reviews of reporting submissions, and ensures regulatory and ad hoc reporting commitments are completed accurately and timely.
• Serves as a trusted resource for contract compliance, proactively identifying gaps, validating data, engaging stakeholders with thoughtful questions, and providing guidance through day-to-day operations and special project initiatives.

Requirements

• Bachelor Degree in Business with 4 years’ experience OR 8 years of experience working in health insurance operations.
• Experience in project development, implementation and execution skills.
• Experience interfacing with internal clients, operations personnel.
• Verbal and written communication skills and ability to represent Medicaid department at committee meetings.
• Experience with interacting effectively with all levels of internal and external customers.
• Experience managing multiple projects effectively.
• Interpersonal, organizational and analytical skills.
• Organizational and leadership skills.

Preferred Job Qualifications

• Experience with managing contract provisions.
• Texas Medicaid experience with knowledge of Medicaid operations, regulatory requirements, and contract compliance.
• Strong reporting and analytics skills, including advanced Excel; Power BI experience preferred.
• Analytical and quality-focused mindset with the ability to validate data, identify gaps or inconsistencies, and ensure reporting outputs are accurate, complete, and actionable.
• Strong organizational and communication skills with the ability to manage multiple deliverables, coordinate with stakeholders, ask effective follow-up questions, and meet reporting deadlines.

Benefits

Commensurate with experience.

Pay

$55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location.

Schedule

This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Sponsorship

Sponsorship is not available.