THIS POSITION WILL BE TELEWORK ELIGIBLE ON A HYBRID BASIS.
About Us:
The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. ODM is implementing the next generation of Ohio Medicaid to fulfill its bold, new vision for Ohio’s Medicaid program – focusing on the individual rather than the business of managed care.
The goals of the next generation of Ohio Medicaid are:
- Emphasize a personalized care experience
- Improve care for children and adults with complex behavioral health needs
- Improve wellness and health outcomes
- Support providers in better patient care and
- Increase program transparency and accountability
What You Will Do at ODM:
Office: Operations
Bureau: Network Compliance
Classification: Medicaid Health Systems Administrator 1 (PN 20046526)
The Ohio Department of Medicaid is seeking a compliance professional to be a part of our Network Management team. As a provider compliance team member your responsibilities will include:
- Monitoring Federal and State policy and regulations (CFRs, OAC, ORC) to ensure Medicaid provider compliance.
- Developing and overseeing procedures to support Federal and State Policy based on program initiatives.
- Conducting reconsideration meetings.
- Manage the correspondence to inquiries from providers & stakeholders
- Managing state and federal databases.
The preferred candidate will have the ability to interpret and operationalize Federal and State policy.
What’s in it for you:
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website ! Our benefits package includes:
Medical Coverage
- Quality, affordable, and competitive medical benefits are offered through the Ohio Med PPO plan.
Dental, Vision and Basic Life Insurance
- Dental, vision and basic life insurance premiums are free after one year of continuous service.
Time Away From Work and Work/Life Balance
- Paid time off, including vacation, personal, and sick leave
- 11 paid holidays per year
- Childbirth/Adoption leave
Ohio Public Employees Retirement System
- OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee’s salary. Visit the OPERS website for more information.
Deferred Compensation
- The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.
Qualifications
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).
Or 12 months experience as a Medicaid Health Systems Specialist, 65293.
Note: education & experience is to be commensurate with approved position description on file.
-Or equivalent of Minimum Class Qualifications for Employment noted above.