Ohio Department of Medicaid · 5 hours ago
Managed Care Policy Administrator (Medicaid Health Systems Administrator 2)
Columbus, OH
Full-time
Onsite
Entry, Mid Level
$43.09/hr - $43.09/hr
2+ years expThe Ohio Department of Medicaid is responsible for administering high-quality, person-centric healthcare in Ohio. The Managed Care Policy Administrator will manage and evaluate policies related to Medicaid Managed Care Programs, ensuring compliance with federal and state regulations and developing policy and guidance for managed care entities.
Government Administration
Responsibilities
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
Qualification
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
Technical Skills: Health Administration
Professional Skills: Attention to Detail, Collaboration, Critical Thinking, Decision Making, Goal Setting, Managing Meetings, Organizing and Planning, Verbal Communication, Written Communication
Company
Ohio Department of Medicaid
The Ohio Department of Medicaid (ODM) delivers health care coverage to more than 3 million Ohioans on a daily basis.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Andrew Stevens
Chief Privacy Officer and Deputy Legal Counsel
Matt Stearmer
Chief Data Officer
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