Member Services Operations and Enrollment Manager (Medicaid Health Systems Administrator 1)

Columbus, NE - USA

Monthly Salary: Not Disclosed

Posted on: 20 days ago

Vacancies: 1 Vacancy

Job Summary

What You Will Do At ODM:

Office:Managed Care

Bureau: Member Services

Classification: Medicaid Health Systems Administrator 1 (PN: )

Job Overview:

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

Overseeing statewide initiatives related to Medicaid health systems access with a focus on managed care enrollment and member services

Managing key components of Ohios Medicaid programs including services for Aged Blind & Disabled (ABD) MAGI and MyCare Ohio populations

Directing membership services operations coordinating audits and special projects and ensuring alignment across multiple stakeholders including County Departments of Job & Family Services (CDJFS) Managed Care Organizations (MCOs) the Managed Care Enrollment Center (MCEC) and other state agencies

Leading efforts related to open enrollment review of MCO member materials tracking of Value Added Benefits and ensuring quality of Medicaid Consumer Hotline phone calls

High-level data analysis community outreach and technical consultation to support access to care and improve member experience

The ideal candidate will be a collaborative leader with strong analytical communication and project management skills capable of navigating complex systems and driving impactful change across Ohios Medicaid landscape.

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.

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.

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.

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.

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

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.

Required Experience:

Manager

What You Will Do At ODM:Office:Managed CareBureau: Member ServicesClassification: Medicaid Health Systems Administrator 1 (PN: )Job Overview:As the Managed Care Operations and Enrollment Manager in the Office of Managed Care Ohio Department of Medicaid (ODM) your responsibilities will include: Overs...