Healthcare Program Manager Policy Management & Development (Medicaid Health Systems Administrator 1)
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Job Location:
Monthly Salary:
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
What You Will Do at ODM:
Office: Policy
Bureau: Health Plan Policy
Classification: Medicaid Health Systems Administrator 1 (PN )
Job Overview:
The Ohio Department of Medicaid (ODM) is seeking an experienced healthcare administrator to join the Policy Management and Development (PMD) Team to assist with developing implementing and managing general provisions of the Ohio Medicaid Program. This team is responsible for developing and implementing Ohio Administrative Code (OAC) rules that apply broadly concerning topics such as fraud/waste/abuse payment coordination of benefits telehealth claim submission prior authorization electronic data interchange and national standards and HIPAA compliant healthcare transactions. As a PMD Healthcare Program Manager your responsibilities will include:
- Becoming a subject matter expert on assigned policies and managing updates to Ohio Administrative Code (OAC) rules the Medicaid State Plan Ohio Medicaid Enterprise System (OMES) and other systems or programs as needed.
- Evaluating and assessing program needs and requirements for improving oversight and enforcement of general provisions.
- Completing updates to OAC rules and the State Plan managing the filing process and implementing necessary changes across the agency to support operations.
- Ensuring policies comply with federal and state regulations rules and laws.
- Evaluating and analyzing policies related to the design and regulatory oversight of general Medicaid provisions as assigned.
- Acting as a policy liaison and collaborating with other areas of ODM sister state agencies and/or external stakeholder groups.
- Communicating with stakeholders and developing instructional or educational materials to support implementation of assigned policies.
Responding to inquiries from internal and external stakeholders regarding assigned policies.
The preferred candidate will have strong writing skills experience researching state/federal laws or regulations and experience developing policy or guidance documents.
Completion of graduate core program in business management or public administration public health health administration social or behavioral science or public finance; 12 mos. the delivery of a 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 base analysis).
-Or 12 months experience has Medicaid Health Systems Specialist 65293 may be substituted for the experience required but not for the mandated licensure if required. Note: education & experience is to be commensurate with approved position description on file.
-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required but not for the mandated licensure.
Job Skills: Health Administration
Technical Skills: Public Health Program Management Technical Writing
Professional Skills: Collaboration Analyzation Written Communication
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services activities programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39) and as outlined in the posting.
About Us:
Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWines agenda for Ohios future. To ensure Ohio is the best place to live work raise and family and start a business we must have strong schools a great quality of life and compassion for those who need our help.
Ohio Department of Medicaid plays a unique and necessary role in supporting the governors vision. As the single state Medicaid agency responsible for administering high-quality person-centric healthcare the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:
- Delivering a personalized care experience to more than three million people served.
- Improving care for children and adults with complex behavioral health needs.
- Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.
- Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.
- Ensuring financial transparency and operational accountability across all Medicaid programs and services.
At the State of Ohio we take care of the team that cares for Ohioans. We provide a variety of quality competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits visit ourTotal Rewards website! Our benefits package includes:
- 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)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
Compensation is as listed on the posting unless required by legislation or union contract.
This position is overtime exempt.
Travel required as needed. Must provide own transportation. Or in order to operate a state vehicle you must have a valid drivers license from state of residence.
Resumes and/or attachments are not reviewed. Therefore please provide detail in the work experience section of your application.
Required Experience:
Manager
Key Skills
- Computer Science
- Active Directory
- Computer information Technology
- PowerShell
- OS
- Windows
- Database
- SCCM
- Linux
- SAN
- Troubleshoot
- Backup
- Setup
- Technical Support
- UNIX
About Company
Department/Division: Job and Family Services- Fayette Ohio Means Job Center Core Hours: Monday-Friday 7:00-5:30Salary Range: Pay Range 6Pay Scale: $18.80 - $23.98Qualified applicants should submit ... View more
