MCO Contract Control Audit Program Manager - (PA3) - 20068987

State of Ohio • Columbus, OH

16h • 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. For a list of all the State of Ohio Benefits, visit our Total Rewards website ! Our benefits package includes: 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 ) Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position. 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. A Little About Us: With roughly 1,500 employees in 7 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. Our Culture: BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups, participate in online forums discussing society’s impact on our services and workplace, and learn about how different perspectives can improve leadership skills. Our Vision: To transform BWC into an agile organization driven by customer success. Our Mission: To deliver consistently excellent experiences for each BWC customer every day. Our Core Values: One Agency, Personal Connection, Innovative Leadership, Relentless Excellence. What our employees have to say: BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include: BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work. I have worked at several state agencies and BWC is the best place to work. Best place to work in the state and with a sense of family and support. I love the work culture, helpfulness, and acceptance I've been embraced with at BWC. I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC. Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. BWC’s core hours of operation are Monday-Friday from 8\:00am to 5\:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7\:00am or as late as 8\:30am. Flex-time schedules are based on operational need and require supervisor approval. What You’ll Be Doing: Position Overview: The MCO Contract Control Program Manager plays a critical role in ensuring Managed Care Organizations (MCOs) meet all contractual, regulatory, and operational requirements. Under the direction of the Director of MCO Business Reporting, this position leads the development and oversight of contract controls, compliance monitoring, and strategic initiatives that support the integrity and performance of the seven contracted managed care organizations (MCOs) working within Ohio’s Health Partnership program (HPP)

Requirements

• 5 yrs. trg. or 5 yrs. exp. in business administration, management or public administration.
• completion of undergraduate core program in business administration, management or public administration; 36 mos. trg. or 36 mos. exp. in supervisory, administrative &/or managerial position.
• completion of undergraduate core program for academic field of study commensurate with program area to be assigned per approved Position Description on File; 36 mos. trg. or 36 mos. exp. in supervisory, administrative, managerial &/or staff position involving planning, research &/or policy/procedure development.
• 1 yr. exp. as Program Administrator 2, 63123.
• equivalent of Minimum Class Qualifications For Employment noted above.
• Knowledge of business administration, management science or public administration; supervisory principles/techniques; public relations; employee training & development; budgeting.
• Ability to define problems, collect data, establish facts & draw valid conclusions; develop complex reports & position papers; handle sensitive face-to-face contacts with public & government officials; establish friendly atmosphere as supervisor of work unit.
• Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.

Nice To Haves

• Prefer graduate level candidate, including master’s degree in business administration, management, health or public administration, or law degree; or a bachelor’s degree in accounting or related field with contract management, audit or compliance experience.

Responsibilities

• Policy Development, Contract Compliance & Oversight Formulate and implement program policies to support the MCO Contract Control, Risk and Compliance Management program.
• Lead the monitoring and enforcement of MCO contract controls (e.g., Business Continuity Plans, cyber insurance, AICPA SOC1/SOC2 compliance).
• Develop and implement policies and operational controls to ensure MCOs comply with contract terms and Ohio regulations.
• Develop the compliance strategy to mitigate Agency risks, and t rack and report MCO compliance status, timelines, and violations to the Director and Medical Services Chief.
• Identify and document contract violations, providing evidence-based reports to leadership and legal teams.
• Initiate and manage strategic projects to support program and policy development and management (e.g., SOC2 training, AI-based continuity evaluations, compliance tracking tools).
• Develop project plans, metrics, and presentation materials for internal governance and external stakeholders.
• Represent the Medical Services Division in cross-divisional and external collaborations.
• Training & Communication Design and deliver internal and external training on MCO contract control programs.
• Serve as a representative on MCO Business Council subcommittees and workgroups.
• Act as a spokesperson for the Director and Division leadership at meetings and events.
• Assist in developing communication strategies for internal staff, stakeholders, and providers.

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