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

State of Ohio•Columbus, OH

4d•Onsite

About The Position

The Performance Improvement Manager is part of the Ohio Department of Medicaid’s Health Innovation & Quality team, within the Health Innovation & Quality Bureau’s Health Research & Quality office. The position manages quality improvement projects for targeted Medicaid populations, including children with chronic conditions. It directs the design of these projects, including work to improve disparate outcomes and care transitions, and directs or conducts research into evidence-based interventions and strategies. The role coordinates identification of applicable quality measures and collection and analysis of health services data to support the design and evaluation of Children with Chronic Conditions quality improvement projects for the OhioRISE Plan. It develops methodologies and timelines for monitoring and evaluating projects, including outcome measurement and population-health impact. The manager ensures compliance with applicable federal and state requirements, manages contracted consultant staff and services supporting quality initiatives for the PIHP, and formulates policy and recommends legislative changes related to these projects. This is a permanent, full-time classified position based at 50 West Town Street, Columbus, Ohio. The employee is required to report to that location full-time. Work hours are 8:00 AM to 5:00 PM, with travel as needed; the employee must provide transportation or have a valid driver’s license to operate a state vehicle. Compensation is listed as $40.40. The position requires completion of a graduate core program in a specified field and relevant health-services experience, or qualifying equivalent experience. A current Ohio registered-nurse license is additionally required if the position oversees assessment or reassessment of clinical appropriateness of services or payment policies related to Medicaid health-services delivery.

Requirements

Completion of a graduate core program in business, management, public administration, public health, health administration, social or behavioral science, or public finance.
Twelve months of experience delivering a health-services program or managing a health-services project, such as 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, or health-services database analysis.
Alternatively, 12 months of experience as a Medicaid Health Systems Specialist (classification 65293) may substitute for the required experience, but not for any mandated licensure.
Equivalent of the stated minimum class qualifications may substitute for the required experience, but not for any mandated licensure.
If the position oversees assessment or reassessment of clinical appropriateness of services, payment policies, or related issues in Medicaid health-services delivery, a current and valid registered-nurse license issued by the Ohio Board of Nursing is required.
Must report to the Columbus work location full-time.
Travel is required as needed; must provide own transportation or hold a valid driver’s license from the state of residence to operate a state vehicle.

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 quality improvement projects, including efforts to improve 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 quality improvement project topics.
Coordinate identification of applicable quality measures and the collection and analysis of health-services data to support design and evaluation of Children with Chronic Conditions projects for the OhioRISE Plan.
Develop methodologies and implementation timelines for monitoring and evaluating projects, including outcome measurement and impact on population health.
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 quality improvement projects.