Texas Medicaid Operations Specialist - Hybrid Richardson, TX

Health Care Service Corporation•Richardson, TX

6d•$55,900 - $123,500•Hybrid

About The Position

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. The Texas Medicaid Reporting and Contract Compliance team 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. The team serves as a primary communication hub between the State and internal stakeholders, ensuring regulatory requirements and contractual obligations are met. This resource is responsible for resolving complex and/or escalated internal and external operational questions, coordinating deliverables across business areas, and partnering 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. The role also supports special projects, analyzes and performs quality reviews of reporting submissions, and ensures regulatory and ad hoc reporting commitments are completed accurately and timely. The ideal candidate will have knowledge of Texas Medicaid regulations, strong reporting and analytical capabilities, and the ability to evaluate information for accuracy, completeness, and compliance. This position 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

Nice To Haves

Experience with managing contract provisions
Experience in Project Management
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.

Responsibilities

Providing operational services, assistance, and program implementation and coordination for day-to-day Texas Medicaid reporting, contract compliance, and operational functions.
Managing communications, deliverables, and reporting commitments with the State of Texas in accordance with BCBSTX's STAR, CHIP, and STAR Kids contracts.
Serving as a primary communication hub between the State and internal stakeholders, ensuring regulatory requirements and contractual obligations are met.
Resolving complex and/or escalated internal and external operational questions.
Coordinating deliverables across business areas.
Partnering 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.
Supporting special projects.
Analyzing and performing quality reviews of reporting submissions.
Ensuring regulatory and ad hoc reporting commitments are completed accurately and timely.
Serving 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.