Performance Improvement Manager - PN 20099235 (Medicaid Health Systems Administrator 1)

State of Ohio • Columbus, OH

5d • Onsite

About The Position

The Performance Improvement Manager is part of the Ohio Department of Medicaid’s Health Innovation & Quality team, within the Health Research & Quality Bureau. The role manages quality improvement projects (QIPs) for targeted Medicaid populations, including Children with Chronic Conditions, and supports related initiatives for the OhioRISE Plan and the prepaid inpatient health plan (PIHP). The position is permanent and full-time, based at 50 West Town Street in Columbus, Ohio, with work hours of 8:00 AM to 5:00 PM. The incumbent must report to the work location full-time. Travel is required as needed, and the employee must provide their own transportation or hold a valid driver’s license from their state of residence to operate a state vehicle.

The position develops and directs QIP design, research, measurement, data analysis, monitoring, evaluation, and reporting. It also reviews applicable requirements for compliance, manages contracted consultant staff and services, and formulates policy and recommends legislative changes related to Children with Chronic Conditions QIPs. Compensation is listed as $40.40; the posting does not specify a pay period.

Applicants must meet the stated education and experience qualifications or an allowed equivalent. A current, valid Ohio registered nurse license is additionally required if the position oversees assessment or reassessment of clinical appropriateness of services, payment policies, or related Medicaid health services delivery issues.

Requirements

• Complete a graduate core program in business, management, public administration, public health, health administration, social or behavioral science, or public finance.
• Have 12 months of experience delivering a health services program or managing a health services project; examples include health care data analysis, health services contract management, health care market and financial expertise, health services program communication, health services budget development, HMO and hospital rate development, health services eligibility, and health services database analysis.
• Alternatively, 12 months of experience as a Medicaid Health Systems Specialist (65293) may substitute for the required experience, but not for any mandated licensure.
• Alternatively, an equivalent of the stated Minimum Class Qualifications for Employment may substitute for the required experience, but not for any mandated licensure.
• If overseeing assessment or reassessment of clinical appropriateness of services, payment policies, or related Medicaid health services delivery issues, hold a current and valid registered nurse license issued by the Ohio Board of Nursing.
• Provide own transportation for required travel, or have a valid driver’s license from the state of residence to operate a state vehicle.
• Report to the Columbus work location full-time if selected.

Responsibilities

• Manage the development, implementation, and reporting of quality improvement projects for targeted Medicaid populations, including Children with Chronic Conditions.
• Direct the design of Children with Chronic Conditions QIPs, including initiatives focused on disparate outcomes and care transitions for consumers with specific disease conditions.
• Direct and/or conduct research into evidence-based interventions and strategies for Children with Chronic Conditions QIP topics.
• Coordinate the identification of applicable quality measures and the collection and analysis of health services data to support the design and evaluation of Children with Chronic Conditions QIPs for the OhioRISE Plan.
• Develop methodologies and implementation timelines for monitoring and evaluating QIPs, including outcome measurement and population health impact.
• Review applicable rules, policies, laws, and guidelines to ensure compliance with CMS requirements and applicable state regulations, rules, and laws.
• Manage and direct contracted consultant staff and services supporting the design, development, implementation, evaluation, and reporting of quality improvement initiatives for the PIHP.
• Formulate policy and recommend legislative changes for Children with Chronic Conditions QIPs.

Benefits

• Medical coverage.
• Free dental, vision, and basic life insurance premiums after completion of the eligibility period.
• Paid time off, including vacation, personal and sick leave, and 11 paid holidays per year.
• Childbirth, adoption, and foster care leave.
• Education and development opportunities, including employee development funds and Public Service Loan Forgiveness.
• Public retirement systems, including OPERS, STRS, SERS, and HPRS, and optional Ohio Deferred Compensation.

What This Job Offers

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