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Medicaid Insurance Jobs in California (NOW HIRING)

VIMO INC.

Medicaid Business Analyst

Mountain View, CA · On-site +1

$120K - $160K/yr

Our innovative approach to health insurance shopping and enrollment has expanded beyond exchanges, and we are now reinventing how states administer safety net programs such as Medicaid, SNAP (food ...

VIMO INC.

Medicaid Business Analyst

Mountain View, CA · On-site

$140K - $170K/yr

Our innovative approach to health insurance shopping and enrollment has expanded beyond exchanges, and we are now reinventing how states administer safety net programs such as Medicaid, SNAP (food ...

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Medicaid Insurance information

What is Medicaid insurance?

Medicaid insurance is a government-funded health coverage program in the United States designed to help low-income individuals and families access medical care. It provides a range of health benefits, including doctor visits, hospital stays, prescriptions, and preventive services, often at little or no cost to eligible participants. Medicaid is jointly funded by federal and state governments, and eligibility criteria can vary by state. The program plays a crucial role in ensuring vulnerable populations receive necessary healthcare services.

What are the key skills and qualifications needed to thrive as a Medicaid insurance specialist?

To thrive as a Medicaid Insurance Specialist, you need deep knowledge of healthcare regulations, Medicaid eligibility requirements, and claims processing, typically supported by a background in healthcare administration or insurance. Familiarity with Medicaid management information systems (MMIS), electronic health records (EHR), and billing software is essential. Attention to detail, strong communication, and problem-solving skills help specialists navigate complex cases and assist clients effectively. These skills ensure accurate processing of claims, compliance with regulations, and timely support for beneficiaries.

What are some common challenges faced by professionals working in Medicaid insurance, and how can they be addressed?

Professionals in Medicaid insurance often navigate complex regulatory requirements and frequent policy changes, which can be challenging to keep up with. Additionally, the role may involve managing high caseloads and addressing the diverse needs of members from various backgrounds. Staying updated through regular training, collaborating closely with team members, and leveraging technology for case management can help address these challenges. Open communication and a strong support network within the organization also contribute to effective problem-solving and professional growth.

What is the difference between Medicaid Insurance vs Medicaid Case Manager?

AspectMedicaid InsuranceMedicaid Case Manager
CredentialsVaries; often none required or state-specific certificationsTypically requires a social work, nursing, or healthcare-related degree and certification
Work EnvironmentInsurance companies, government agencies, healthcare providersCommunity settings, healthcare facilities, government offices
Employer & IndustryHealth insurance providers, government programsState Medicaid agencies, healthcare organizations
Job FocusCoverage, policy management, billingClient advocacy, eligibility, care coordination

Medicaid Insurance involves managing coverage policies and billing, while Medicaid Case Managers focus on assisting clients with eligibility, care plans, and resource coordination. Both roles are essential in the Medicaid system but serve different functions within the healthcare industry.

How do you become a Medicaid Insurance specialist?

To become a Medicaid Insurance specialist, individuals typically need a high school diploma or equivalent, with some roles requiring a bachelor's degree in health administration, social work, or related fields. Relevant skills include knowledge of Medicaid policies, strong communication, and proficiency with healthcare management software; certifications such as Certified Medicaid Specialist can enhance job prospects.

How to become a Medicaid insurance case worker?

To become a Medicaid insurance case worker, candidates typically need a high school diploma or equivalent, with some positions requiring an associate's or bachelor's degree in social work, healthcare, or a related field. Relevant skills include knowledge of Medicaid policies, strong communication, and computer proficiency; certification or training in case management may also be beneficial. Employment often requires background checks and familiarity with healthcare management systems.

What are popular job titles related to Medicaid Insurance jobs in California?

For Medicaid Insurance jobs in California, the most frequently searched job titles are:

What job categories do people searching Medicaid Insurance jobs in California look for?

The top searched job categories for Medicaid Insurance jobs in California are:

What cities in California are hiring for Medicaid Insurance jobs?

Cities in California with the most Medicaid Insurance job openings:

Medicaid Insurance jobs near you
Infographic showing various Medicaid Insurance job openings in California as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Medicaid Business Analyst

VIMO INC.

Mountain View, CA • On-site, Remote

$120K - $160K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Job description

About Vimo:
Vimo® started as the "Expedia" of health insurance and has evolved into a leader in transforming government IT infrastructure with its proven SaaS and AI technology. Our innovative approach to health insurance shopping and enrollment has expanded beyond exchanges, and we are now reinventing how states administer safety net programs such as Medicaid, SNAP (food stamps), child care, and unemployment insurance. With our cutting-edge technology, we are helping agencies serve more people, faster, and transforming healthcare service delivery as we know it.
Job Summary:
The Business Analyst is responsible for the end-to-end integrity of Account Transfer (AT) XML data exchanges between the State Exchange and the Medicaid Management Information System (MMIS). You will perform gap analysis on XML schemas, define field-level mapping, and coordinate directly with Medicaid partners to ensure seamless data flow in production.
Key Responsibilities:
  • XML Data & Gap Analysis:
    • Review and analyze Account Transfer XML files to identify data discrepancies, structural gaps, or missing fields between the Exchange and Medicaid systems.
    • Troubleshoot and resolve production data issues related to failed or "stuck" account transfers.
  • Field-Level Mapping & Documentation:
    • Lead the coordination with Medicaid stakeholders to define and maintain Source-to-Target Mapping (STTM) documents for all shared data elements.
    • Maintain a centralized repository of agreed-upon mapping logic, data dictionaries, and transformation rules.
  • Medicaid Liaison & Traffic Monitoring:
    • Act as the primary point of contact for Medicaid agencies, conducting regular "pulse checks" to monitor system-to-system traffic health.
    • Report on transmission success rates and proactively identify trends in data rejection or service interruptions.
  • Integration Testing & Validation:
    • Support System Integration Testing (SIT) and User Acceptance Testing (UAT) by developing test cases specifically for data mapping and XML validation.
    • Verify that incoming data correctly triggers the intended enrollment actions in the target system.

Basic Qualifications:
  • Technical Skills: Proficiency in reading and validating XML/XSD; strong SQL skills for data reconciliation; experience with EDI or health data standards (HL7/NIEM).
  • Experience: 3-5+ years in Medicaid, Healthcare IT, or Insurance Exchange environments with a focus on data integration.
  • Analytical Ability: Proven experience in Gap Analysis and complex data mapping.
  • Communication: Strong ability to translate technical XML issues into business impacts for Medicaid stakeholders and vice versa

Compensation and Benefits:
  • Competitive compensation - All In range of ($140,000-$170,000). (Please note that salary and compensation may vary based on factors such as skills, experience, performance and location.)
  • We offer a comprehensive benefits package, including but not limited to:
  • Health, Dental, Life, Disability, and Vision insurance
  • Healthcare spending or reimbursement accounts (HSA/FSA)
  • Retirement benefits (401k)
  • Paid time off
  • Holidays: 13 paid days per year
  • Education assistance or tuition reimbursement-
  • Employee discounts for Gym memberships & commuting/travel assistance

Our Vaues:
  • We believe that working hard, when it is imbued with purpose, can and should be fun.
  • You'll find we are a "can do" place where people work together and roll up their sleeves to get the job done.
  • Everyone has a voice; everyone's ideas count, and everyone is respected.
  • We have built a company, as well as a community of friends and colleagues, with respect for each other.

Information Security & Data Protection:
  • This role may involve access to sensitive or regulated information. The candidate is expected to handle all data in accordance with company security, privacy, and data protection policies.
  • Compliance with access control, data classification, and applicable legal and regulatory requirements is required.

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