Medicaid Policy Operations Manager

Job Summary

To support market access strategy, the full-time remote Medicaid Policy Operations Manager will serve as the internal subject matter expert on Medicaid reimbursement requirements, monitor state policies, and translate insights into actionable guidance for the Revenue Cycle Team.

Key responsibilities

• Monitor state Medicaid fee schedules and program requirements to identify changes affecting reimbursement and operational execution
• Serve as a subject matter expert on state-specific Medicaid reimbursement, including EPSDT processes and claim submission considerations
• Analyze claims data and denial trends to identify root causes and recommend data-informed process improvements

Required qualifications

• Bachelor's degree in healthcare, public policy, business, or related field preferred
• 4-7+ years of experience in Medicaid policy or operations
• Experience working within a Medicaid agency or managed care organization strongly preferred
• Hands-on experience with EPSDT programs strongly preferred
• Strong proficiency in Excel and experience analyzing claims data