Senior Healthcare Program Specialist - Specialized Services for Children
About The Position
The Bureau of Specialized Services for Children (BSSC) within the Division of Program Development & Management (DPDM) oversees Medicaid program policy for a broad range of children’s services, including: Children’s Health Home Program Voluntary Foster Care Agencies (VFCA) 29‑I Health Facilities Home and Community Based Services (HCBS) Children’s Waiver The Senior Healthcare Program Specialist 1 will utilize their healthcare experience to develop proficiency in assigned program areas and support Medicaid program implementation, policy updates, program analysis, care management activities, and provider/stakeholder engagement. The role includes providing basic care management services to HCBS participants who opt out of Health Home care management.
Requirements
- 9 years of experience in healthcare
- (Associate’s = 2 years, Bachelor’s = 4 years, Master’s = 5 years of credited experience)
Nice To Haves
- Strong interpersonal, critical thinking, and decision‑making skills
- Knowledge of pediatric diagnoses and health conditions affecting development and activities of daily living
- Experience with pediatric home health, care management, or medical support services
- Knowledge of Medicaid programs and services
- Background in social work or experience supporting populations such as: Serious Emotional Disturbance (SED), Foster Care, Medically Fragile youth, Developmental Disabilities, Substance Use Disorders, Other chronic conditions
- Excellent time‑management and organizational skills
Responsibilities
- Develop expertise in Medicaid children's programs including Health Homes, HCBS Children’s Waiver, CFTSS, and Foster Care/29‑I.
- Draft policies, procedures, training materials, PowerPoints, webinars, and guidance documents.
- Review and update provider guidance materials and assist with website updates.
- Analyze program processes, reports, and data to identify gaps and recommend improvements.
- Provide basic care management services to HCBS participants, including: Developing plans of care, Conducting quarterly check‑ins, Coordinating services and referrals, Completing annual eligibility assessments
- Maintain case documentation, filing systems, and tracking tools.
- Monitor reports and present updates to leadership on care management activity.
- Become proficient with management information systems and recommend process improvements.
- Evaluate implementation strategies and recommend enhancements.
- Synthesize program information to identify needed changes to services or procedures.
- Collaborate with internal staff, contractors, and state partners on Health Homes, HCBS, and State Plan children’s services.
- Engage providers and stakeholders to support program implementation.
- Participate in additional activities as needed to support evolving OHIP priorities.
Benefits
- Health, vision, and dental insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
- Additional perks that support
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
