Managed Care Provider Agreement Manager (Medicaid Health Systems Administrator 1)

State of Ohio • Columbus, OH

21d

About The Position

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help. Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by: Delivering a personalized care experience to more than three million people served. Improving care for children and adults with complex behavioral health needs. Working collectively with our partners and providers to measurably strengthen wellness and health outcomes. Streamlining administrative burdens so doctors and healthcare providers have more time for patient care. Ensuring financial transparency and operational accountability across all Medicaid programs and services. What You Will Do At ODM: Office \: Managed Care Bureau : Managed Care Compliance & Oversight Classification: Medicaid Health Systems Administrator 1 (PN\: 20047489 ) Job Overview: As Managed Care Provider Agreement Manager , your responsibilities will include:

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.
• The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Responsibilities

• Developing and maintaining relationships with Managed Care Entities and stakeholders
• Analyzing contract language
• Organizing and reviewing contract language from various areas
• Developing, monitoring, and tracking changes to contract
• Maintaining a repository of contract changes
• Developing and delivering presentations to MCEs, ODM Leadership, and various stakeholder groups
• Evaluating the need to revise related Medicaid eligibility policies and procedures.
• Submitting proposals to CMS using CMS authorized portals
• Developing and maintaining various Teams channels

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: Manager