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Job Summary

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.

Required Job Qualifications:

• 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

• 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.

• Location: Richardson, TX Headquarters

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

• Sponsorship: Sponsorship is not available.

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Pay Transparency Statement:

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.

HCSC Employment Statement:

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.

Base Pay Range

$55,900.00 - $123,500.00

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