Managed Care Policy Administrator; Medicaid Health Systems Administrator

Overview

What You Will Do At ODM:

Office
:
Managed Care

Bureau
:
Policy & Program Development

Classification
:
Medicaid Health Systems Administrator 2 (PN:  )

As the Managed Care Policy Administrator in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities may include:

• Planning, managing, evaluating, and analyzing policies related to member and provider contracted deliverables in Medicaid Managed Care Programs
• Implementing Medicaid State Plan Amendment (SPA) and Ohio Administrative Code (OAC) rule changes, changes to managed care programs
• Communicating responsibility and obligation of managed care entities (MCEs) to individuals and other government agencies
• Developing policy, provider agreements and guidance memorandum
• Providing additional direction in the processing of provider agreements, administrative rules, state directed payments, and federal authorities
• Assisting in providing strategic oversight of policies and procedures governing Medicaid managed care
• Ensuring that managed care program policies and procedures comply with federal and state regulations by researching applicable regulations and working with appropriate ODM staff, federal and state agencies
• Assisting higher level administrators in development and coordination of overall programs relating to Medicaid health delivery systems and contacting managed care plans
• Formulating policy and recommends legislative and programmatic changes

Education & Experience

• Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 24 mos. exp. in planning & administering 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 analysis).
• Or 24 months experience as a Medicaid Health Systems Administrator 1, 65295.
  
  Note:
  
  education & experience is to be commensurate with approved position description on file.
• Or equivalent of Minimum Class Qualifications for Employment noted above.

Health Administration

Attention to Detail, Collaboration, Critical Thinking, Decision Making, Goal Setting, Managing Meetings, Organizing and Planning, Verbal Communication, Written Communication