• Facilitate successful implementation of Medicaid health plan operations programs by coordinating with cross-functional teams • Enhance operational efficiency, ensure compliance with regulatory standards, and contribute to overall healthcare operations success • Assist in the management of stakeholder relationships and establish communication channels regarding claims payment, contract or benefit setup • Collect, analyze, and interpret operational data to identify trends and insights for decision-making and improvements • Analyze operational issues, provider complaints, and propose solutions • Apply knowledge of medical coding and billing to ensure accurate claims processing • Review and analyze complex claim documentation and assess policy coverage • Identify potential risks that could impact health plan operations and develop proactive mitigation plans • Ensure program deliverables meet quality standards and comply with relevant regulations and best practices • Implement change management strategies during program implementation