The United States is in the midst of an unprecedented national effort to manufacture, distribute, and ultimately administer COVID-19 vaccines to all Americans. While the federal government is coordinating distribution of vaccines from manufacturers to states, individual states (and certain municipalities) are responsible for coordinating the various components of infrastructure and operational logistics needed to take the vaccine from federal distribution channels to the arms of Americans. This expert perspective outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population.