Texas Medicaid Operations Specialist - Hybrid Texas

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

• 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

• Experience with managing contract provisions
• Experience in Project Management
• Direct experience supporting Texas Medicaid managed care operations, preferably within a Medicaid Managed Care Organization (MCO), healthcare services organization, delegated entity, or vendor supporting a Texas Medicaid population.
• Working knowledge of the Texas Medicaid and CHIP Uniform Managed Care Manual (UMCM) and the Uniform Managed Care Contract (UMCC) requirements to ensure that   and the and experience interpreting or applying UMCM requirements to operational processes, reporting, deliverables and , or compliance activities are compliant.
• Hands-on experience with Texas Medicaid Utilization Management (UM) and/or Care Management (CM) operations.
• Experience working with or interpreting Texas Medicaid managed care contract requirements, including the relationship between contract requirements, UMCM guidance, and operational execution.
• Experience monitoring operational performance or compliance, identifying gaps, validating deliverables/data, and coordinating corrective actions or operational improvements.
• Strong reporting and data-analysis skills, including advanced Microsoft Excel; Power BI/dashboard development or reporting experience strongly preferred.
• Experience with managing contract provisions
• Experience in Project Management
• Ability to analyze complex Medicaid operational requirements and translate them into clear business requirements, processes, reporting, and actionable recommendations.
• Location: Richardson, TX or Austin, TX offices
• Schedule: This is a Flex (Hybrid) role: 3 days in office; 2 days remote.
• Sponsorship: Sponsorship is not available

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At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Exact compensation may vary based on skills, experience, and location.