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State of Ohio · 1 day ago

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

William Green Building30 West Spring Street

Full-time

Onsite

Senior Level

5+ years exp

The State of Ohio's Bureau of Workers' Compensation is seeking an MCO Contract Control Audit Program Manager to ensure Managed Care Organizations meet contractual, regulatory, and operational requirements. This role involves overseeing compliance monitoring, policy development, and strategic initiatives to enhance the performance of contracted MCOs.

Automotive

Responsibilities

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 track 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

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

Qualification

Program ManagementContract CompliancePolicy DevelopmentBusiness AdministrationRisk ManagementSupervisory PrinciplesPublic RelationsEmployee TrainingBudgeting

Required

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

Preferred

Graduate level candidate, including master's degree in business administration, management, health or public administration, or law degree

Bachelor's degree in accounting or related field with contract management, audit or compliance experience

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)

Company

State of Ohio

Glassdoor3.8

Employment with the State of Ohio is more than ‘just a job’ – it is a privilege to serve our families, friends and neighbors who rely on us throughout our great state.

Founded in 1803

Columbus, Ohio, USA

10001+ employees