Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

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.

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.

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.

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.

What You Will Do At ODM:

Office:Managed Care

Bureau: Contract Management & Compliance

Classification: Medicaid Health Systems Administrator 1 (PN: )

Job Overview:

As the Managed Care Contract Manager in the Office of Managed Care Ohio Department of Medicaid (ODM) your responsibilities will include:

Managing program information and conducting analyses to inform and direct policy changes and updates

Conducting evaluations for managed care plans

Performing research and answering questions related to legislative and policy initiatives such as implementation and ongoing assessment of new programs populations and/or initiatives

Leading on managed care related contract issues implementations and targeted reviews

Working with the managed care plans to identify areas of concern and provide technical assistance as needed.

Reviewing and approving submitted deliverables and reports

Communicating any compliance actions to the assigned Managed Care Plans

There are 5 MyCare Plansand7Managed Care Organizations (MCOs) that you will be working with.

MyCare Plans:

Aetna Better Health of Ohio Inc.

Buckeye Health Plan

CareSource

Molina HealthCare of Ohio Inc.

UnitedHealthcare Community Plan

Managed Care Organizations (MCOs)

AmeriHealth Caritas Ohio Inc.

Anthem Blue Cross and Blue Shield

Buckeye Health Plan

CareSource

Humana Healthy Horizons in Ohio

Molina HealthCare of Ohio Inc.

UnitedHealthcare Community Plan

Completion of graduate core program in business management or public administration public health health administration social or behavioral science or public finance; 12 monthsexperiencein 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 as a Medicaid Health Systems Specialist 65293.

-Or equivalent of Minimum Class Qualifications for Employment noted above.

Technical Skills: Health Administration

Professional Skills:Collaboration Confidentiality Continuous Improvement Innovation Verbal Communication Written Communication

Supplemental Information:

Compensation is as listed on the posting unless required by legislation or union contract.

This positions 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.

Candidates selected for an interview will be required to complete a written assessment as part of the interview process.