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Ohio Department of Developmental Disabilities · 4 hours ago

Medicaid Health Systems Administrator 2 (pn 20102249)

Columbus, OH

Full-time

Onsite

Entry, Mid Level

$43.09/hr - $43.09/hr

2+ years exp

The Ohio Department of Developmental Disabilities is focused on providing support to individuals with developmental disabilities. The Medicaid Health Systems Administrator 2 is responsible for overseeing the management and enhancement of Medicaid services, leading projects for improvement, analyzing data, and ensuring compliance with regulations.

Government Administration

Growth Opportunities

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 developmentCost analysisProject managementData analysisStakeholder engagementRegulatory complianceResearchCollaborationResults orientedStrategic thinking

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

Health Administration

Project Management

Research

Collaboration

Strategic Thinking

Results Oriented