Care Coordination Oversight Manager (Medicaid Health Systems Administrator 1)
About The Position
The Ohio Department of Medicaid (ODM) is seeking a healthcare professional to be part of our Managed Care Care Coordination Team. This position will provide care coordination oversight for the following Managed Care Organizations (MCOs): UnitedHealthcare Humana Healthy Horizons As a Care Coordination Oversight Manager, your responsibilities will include: Overseeing and monitoring care coordination delivery services provided by ODM's MCOs. Providing oversight in the development of innovative program initiatives designed to improve access to health services. Overseeing the coordination of policy and program planning by researching delivery systems within a population health model and providing feedback on findings. Reviewing, analyzing, and interpreting data (e.g. analysis data collected from consumer surveys) and reports and providing recommendations for follow up activities related to performance. Overseeing external quality review activities, including the development of administrative reports. Working collaboratively with internal and external stakeholders across a variety of departments, levels, state agencies, and MCOs to improve care coordination for the individuals served by ODM.
Requirements
- 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 has 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.
Nice To Haves
- Licensed Social Worker
- Licensed Professional Counselor
- Registered Nurse
- Licensed Allied Health Professional
Responsibilities
- Overseeing and monitoring care coordination delivery services provided by ODM's MCOs.
- Providing oversight in the development of innovative program initiatives designed to improve access to health services.
- Overseeing the coordination of policy and program planning by researching delivery systems within a population health model and providing feedback on findings.
- Reviewing, analyzing, and interpreting data (e.g. analysis data collected from consumer surveys) and reports and providing recommendations for follow up activities related to performance.
- Overseeing external quality review activities, including the development of administrative reports.
- Working collaboratively with internal and external stakeholders across a variety of departments, levels, state agencies, and MCOs to improve care coordination for the individuals served by ODM.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Industry
Executive, Legislative, and Other General Government Support
Number of Employees
5,001-10,000 employees
