Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

State of Ohio • Columbus, OH

5d • Onsite

About The Position

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. The Agency Contact listed above will be able to provide specific benefits information for this position. What You Will Do At ODM: Office: Managed Care Bureau: Contract Management & Compliance Classification: Medicaid Health Systems Administrator 1 (PN: 20046515) Job Overview: As the Managed Care Contract Manager in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include: · 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 There are 4 MyCare Plans and 7 Managed Care Organizations (MCOs) that you will be working with. MyCare Plans: · Anthem Blue Cross and Blue Shield · Buckeye Health Plan · CareSource · Molina HealthCare of Ohio, Inc. Managed Care Organizations (MCOs) · AmeriHealth Caritas Ohio, Inc. · Anthem Blue Cross and Blue Shield · Buckeye Health Plan · CareSource · Humana Healthy Horizons in Ohio · Molina HealthCare of Ohio, Inc. · UnitedHealthcare Community Plan

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

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 )

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level