Ohio BWC (official) · 1 day ago
MCO Contract Control Audit Program Manager - (PA3) - 20068987
Ohio BWC is a state agency focused on promoting workplace safety and providing care to injured workers. The MCO Contract Control Program Manager is responsible for ensuring that Managed Care Organizations meet contractual, regulatory, and operational requirements, leading policy development, compliance monitoring, and strategic initiatives.
Employee BenefitsInsuranceTraining
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
Required
5 yrs. trg. or 5 yrs. exp. in business administration, management or public administration
Or 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
Or 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
Or 1 yr. exp. as Program Administrator 2, 63123
Or equivalent of Minimum Class Qualifications For Employment noted above
Knowledge of business administration, management science or public administration; supervisory principles/techniques; public relations; employee training & development; budgeting
Ability to define problems, collect data, establish facts & draw valid conclusions; develop complex reports & position papers; handle sensitive face-to-face contacts with public & government officials; establish friendly atmosphere as supervisor of work unit
Preferred
Prefer graduate level candidate, including master's degree in business administration, management, health or public administration, or law degree; or a bachelor's degree in accounting or related field with contract management, audit or compliance experience
Company
Ohio BWC (official)
BWC helps thousands of injured workers and their employers each year by providing support, resources, and services to ensure workplace safety and recovery.
Funding
Current Stage
Late StageLeadership Team
Recent News
2025-01-04
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2022-01-28
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