{"id":1143661,"url":"https://alion.io/job/health-care-service-corporation-texas-medicaid-operations-specialist-hybrid-richardson-tx","title":"Texas Medicaid Operations Specialist - Hybrid Richardson, TX","company":{"id":20294,"name":"Health Care Service Corporation","domain":"hcsc.com","url":"https://alion.io/company/health-care-service-corporation","size_band":"1001-5000","is_staffing_agency":false,"is_intermediary":false,"ats_vendor":"Workday","truth_index":{"grade":"A","score":90,"open_postings":15,"ghost_share":0,"stale_share":0.533,"repost_share":0.133,"time_to_fill_p50_days":8,"computed_at":"2026-09-24T05:45:00Z"}},"role":"Operations","role_family":"Operations","seniority":null,"employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"hiring_geo_confidence":"structured","locations":["Richardson, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":55900,"max":123500,"currency":"USD","period":"year","gross":null,"usd_annual":123500},"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":false},{"name":"Power BI","optional":false}],"status":"live","first_seen_at":"2026-09-23T13:44:58Z","employer_posted_date":"2026-09-23","last_verified_at":"2026-09-24T01:01:15Z","board_verified":true,"closed_at":null,"days_open":0,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":0},"description":"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.\nJoin HCSC and be part of a purpose-driven company that will invest in your professional development.\nJob Summary\nThis position is responsible for providing operational services, assistance, and program implementation and coordination for one or more of the day-to-day Medicaid operational functions, including Utilization Management (UM), Care Management (CM), reporting, compliance, billing, claims, enrollment, and customer service.This resource is responsible for resolving complex and/or escalated internal or external operational questions. Additionally, this position works with other areas of the organization on the development, testing, and implementation of program policies, business processes, reporting solutions, and system changes to ensure the state requirements of the plan are met. The role will have a particular focus on Texas Medicaid managed care operations, including interpreting and supporting requirements outlined in the Texas Medicaid and CHIP Uniform Managed Care Manual (UMCM) and applicable managed care contracts, while using data and reporting to monitor operational performance, identify gaps, and support compliance.\nRequired Job Qualifications:\nBachelor Degree in Business with 4 years’ experience OR 8 years of experience working in health insurance operations\nExperience in project development, implementation and execution skills\nExperience interfacing with internal clients, operations personnel\nVerbal and written communication skills and ability to represent Medicaid department at committee meetings\nExperience with interacting effectively with all levels of internal and external customers\nExperience managing multiple projects effectively\nInterpersonal, organizational and analytical skills\nOrganizational and leadership skills\nPreferred Job Requirements:\nExperience with managing contract provisions\nExperience in Project Management\nDirect 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.\nWorking 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.\nHands-on experience with Texas Medicaid Utilization Management (UM) and/or Care Management (CM) operations.\nExperience working with or interpreting Texas Medicaid managed care contract requirements, including the relationship between contract requirements, UMCM guidance, and operational execution.\nExperience monitoring operational performance or compliance, identifying gaps, validating deliverables/data, and coordinating corrective actions or operational improvements.\nStrong reporting and data-analysis skills, including advanced Microsoft Excel; Power BI/dashboard development or reporting experience strongly preferred.\nExperience with managing contract provisions\nExperience in Project Management\nAbility to analyze complex Medicaid operational requirements and translate them into clear business requirements, processes, reporting, and actionable recommendations.\nLocation: Richardson, TX Headquarters \n Schedule: This is a Flex (Hybrid) role: 3 days in office; 2 days remote.\nSponsorship: Sponsorship is not available\nAre you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!\nPay Transparency Statement:\nAt 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.\nThe compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.\nHCSC Employment Statement:\nWe 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.\nBase Pay Range\n$55,900.00 - $123,500.00Exact compensation may vary based on skills, experience, and location.","description_format":"text","description_chars":5145,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":["Health insurance","Life insurance","Parental leave","Professional development"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Care","Insurance"],"lifecycle":[{"event":"open","at":"2026-09-23T13:44:58Z"}],"liveness":{"score":63,"band":"ok","label":"Likely open","p_open":1,"p_active":0.632,"p_room":1,"age_days":0,"expected_fill_days":8,"reasons":["conf:4","stale_co","velocity","win:early","comp:brand"],"computed_at":"2026-09-24T05:45:00Z"},"pay":{"stated_usd_annual":123500,"is_top_pay":false},"html_url":"https://alion.io/job/health-care-service-corporation-texas-medicaid-operations-specialist-hybrid-richardson-tx","json_url":"https://alion.io/job/health-care-service-corporation-texas-medicaid-operations-specialist-hybrid-richardson-tx.json","meta":{"generated_at":"2026-09-24T07:27:10Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers"}}