Managed Care Contract Manager (Medicaid Health Systems Administrator 1)
About The Position
The Ohio Department of Medicaid (ODM) plays a crucial role in supporting the governor's vision for Ohio's future by administering high-quality, person-centric healthcare. ODM is committed to supporting the health and wellbeing of nearly one in every four Ohioans. This involves delivering personalized care, improving care for individuals with complex behavioral health needs, strengthening wellness and health outcomes through collaboration, streamlining administrative burdens for healthcare providers, and ensuring financial transparency and operational accountability across all Medicaid programs and services. This specific role is within the Managed Care Bureau, focusing on Contract Management & Compliance, classified as a Medicaid Health Systems Administrator 1.
Requirements
- Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 months experience 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.
- Or equivalent of Minimum Class Qualifications for Employment noted above.
- Technical Skills: Health Administration
- Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication
- Must provide own transportation.
- Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.
Nice To Haves
- Travel required, as needed.
Responsibilities
- Managing program information and conducting analyses to inform and direct policy changes and updates.
- Conducting evaluations for managed care plans.
- Performing research and answering questions related to legislative and policy initiatives such as implementation and ongoing assessment of new programs, populations and/or initiatives.
- Leading on managed care related contract issues, implementations, and targeted reviews.
- Working with the Managed Care plans to identify areas of concern and provide technical assistance as needed.
- Reviewing and approving submitted reports and deliverables outlined in the Managed Care Provider Agreements.
- Communicating any compliance actions to the assigned Managed Care Plans.
Benefits
- Medical Coverage
- Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
- Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
- Childbirth, Adoption, and Foster Care leave
- Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
- Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation )
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
