Medicaid Health Systems Administrator 2 (pn 20102249) jobs in United States
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State of Ohio · 4 hours ago

Medicaid Health Systems Administrator 2 (pn 20102249)

The State of Ohio is seeking a Medicaid Health Systems Administrator 2 to oversee the management and enhancement of Medicaid services. This role involves leading projects, analyzing data, developing policies, and ensuring compliance with regulations to improve healthcare access for individuals with developmental disabilities.

Automotive

Responsibilities

Lead cross-functional projects to evaluate, enhance, and implement Medicaid services and programs, ensuring they meet quality, cost, and efficiency goals
Oversee the planning, execution, and monitoring of projects from initiation to completion
Manage resources effectively, including staff, budgets, and timelines, to achieve project goals
Provide leadership and direction to project teams and ensure project milestones are met
Analyze Medicaid service data, including expenditures, service authorizations, and program performance
Ensure the accuracy and consistency of data entered into Medicaid systems, identifying and correcting discrepancies when necessary
Prepare and present regular reports on program performance, cost savings, and other key metrics
Use data to drive decision-making, program improvements, and policy changes
Develop, revise, and implement Medicaid policies and procedures to ensure compliance with state and federal regulations
Evaluate the effectiveness of policies and recommend changes to improve service delivery, cost-effectiveness, and patient outcomes
Work with internal and external stakeholders to ensure alignment and understanding of new and revised policies
Monitor the implementation of policies and conduct periodic reviews to assess their impact
Direct and administer initiatives to support system innovations and technical assistance
Use clinical background to conduct reviews of Individual Service Plans and related service authorizations to make recommendations on service improvement and service authorization
Evaluate and direct activities that support DODD HCBS waiver utilization management
Analyze service delivery costs and implement strategies to improve cost-efficiency without compromising the quality of care
Review and manage high-cost services, ensuring they are cost-effective and meet the needs of individuals
Work with service providers and other stakeholders to identify cost-saving opportunities and enhance service delivery
Conduct cost-benefit analyses for Medicaid waivers, services, and programs
Work collaboratively with multiple internal teams, county boards, external agencies, and service providers to ensure Medicaid programs are effectively managed and aligned with organizational objectives
Facilitate discussions and negotiations with stakeholders to resolve issues, align goals, and achieve consensus on policy initiatives
Provide clear and effective communication to all stakeholders regarding policy updates, program changes, and best practices
Ensure Medicaid programs and services comply with all relevant state and federal regulations, guidelines, and policies
Conduct regular audits to assess program compliance and identify potential risks or areas for improvement
Stay updated on changes in Medicaid regulations and adjust practices accordingly to ensure ongoing compliance
Develop and deliver training materials for staff on Medicaid policies, service delivery standards, and system processes
Provide ongoing support to staff to ensure they are equipped to deliver high-quality services
Create and deliver presentations on complex Medicaid topics to various audiences, ensuring material is easily understood
Identify opportunities for process improvements in Medicaid service delivery, ensuring that all operations are running efficiently and cost-effectively
Work with teams to resolve any issues related to program underperformance or service quality concerns
Lead initiatives to improve the overall quality of Medicaid services and ensure continuous improvement in service delivery

Qualification

Medicaid program managementPolicy developmentData analysisCost analysisProject managementStakeholder engagementCommunicationProblem solvingCollaborationStrategic thinkingResults oriented

Required

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
Job Skills: Health Administration, Project Management, Research, Collaboration, Strategic Thinking, Results Oriented
The final candidate selected for the position will be required to undergo a criminal background check
The final applicant selected for this position will be required to submit to urinalysis prior to the appointment to test for illegal drug use
Requires travel throughout State of Ohio & may require overnight stay
Must be willing & able to secure a Driver License OR supply your own transportation

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

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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.

Funding

Current Stage
Late Stage

Leadership Team

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Beverlyn Johns, MS
Deputy Chief Operating Officer
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Holly Drake
State Chief Information Security Officer
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