Texas Medicaid Operations Specialist - Hybrid Texas
Core
Provides operational services, assistance, and program implementation for Texas Medicaid managed care functions including Utilization Management, Care Management, reporting, compliance, and billing.
Role type
Senior IC Medicaid Operations Specialist
Builds
Operational processes, reporting solutions, and system changes for Texas Medicaid managed care
Domain
US Healthcare / Medicaid Managed Care
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Medicaid operations, Utilization Management, Care Management, project management, contract interpretation, data analysis, Microsoft Excel, Power BI, compliance monitoring
Preferred skills
Project Management, Texas Medicaid UMCM/UMCC expertise, advanced Power BI/dashboard development, complex requirement translation
Technologies
Microsoft Excel, Power BI
Responsibilities
Resolve complex operational questions, develop and implement program policies and business processes, monitor operational performance and compliance, validate deliverables and data, coordinate corrective actions
Seniority
Senior, hands-on IC