Medicaid Health Systems Specialist (PN )

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.

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.

Who Are We

The Department of Developmental Disabilities (DODD) is a trauma informed care agency focused on implementing our core values and providing support to people with developmental disabilities. We oversee a statewide system of supportive services that focus on ensuring the health and safety supporting access to community participation and increasing opportunities for meaningful employment. To learn more about DODD clickhere.

The Division of Medicaid Development and Administration works with state agency personnel and stakeholders to develop policies related to Medicaid-funded services for people with developmental disabilities. Responsibilities include drafting waiver applications statutes rules and guidance for home and community-based services waivers.

• No additional materials will be accepted after the closing date; in addition you must clearly demonstrate how you meet minimum qualifications.
• The final candidate selected for the position will be required to undergo a criminal background check. RuleBackground Investigations for Employment outlines disqualifying offenses that will preclude an applicant from being employed by the Department of Developmental Disabilities.
• Hourly wage will be paid at step 1 unless otherwise specified bycollective bargaining agreement or rules outlined in the ORC/OAC.
• Requires travel throughout State of Ohio & may require overnight stay.

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.

Join Our Team!

Accepting applications for:

Medicaid Health Systems Specialist

What will you do

The Medicaid Health Systems Specialist serves as a key team member responsible for reviewing coordinating and responding to inquiries regarding services and supports through a formalized statewide communication system. This position plays a central role in supporting system innovation policy interpretation and technical assistance related to Medicaid services for individuals with developmental disabilities.

Communication & Coordination

• Review coordinate and respond to inquiries related to services and supports via a statewide communication system
• Compose and manage responses to correspondence and field inquiries.
• Provide information to constituents individuals with developmental disabilities (DD) families healthcare providers county boards of DD (CB/DD) associations and government agencies.
• Ensure health safety service quality and satisfaction through clear and accurate communication.

Policy Program & System Support

• Assist in developing and implementing Medicaid policy goals and objectives for departmental programs and initiatives.
• Design systems and procedures to assess program outcomes.
• Provide data and narrative components for biennial budget requests.
• Support system innovations and technical assistance related to statewide Medicaid services grants interagency agreements and self-determination efforts.
• Participate in rule and statute review revision and promulgation.
• Respond to and assist with requests for waivers of Ohio Administrative Code requirements.

Training & Technical Assistance

• Provide interpretation guidance and implementation support for Medicaid rules regulations and policies.
• Deliver training sessions webinars and statewide or regional activities to ensure consistent policy application.
• Collaborate with team members to develop training content for all components of the Medicaid Service System (MSS).
• Offer daily system assistance to the field including CB/DDs providers individuals families and advocates.

Systems & Technology

• Utilize and support field use of key systems including:
  • Medicaid Information Technology System (MITS)
  • Imagine365 CRM
  • Other required technology platforms
• Review documents for accuracy clarity and professional presentation.
• Develop materials and presentations for training technical assistance and publication.
• Participate in system development testing feedback implementation and recommendations for improvement.

Stakeholder Engagement & Representation

• Act as liaison to regional organizations (e.g. Ohio Association of Adult Services Ohio Superintendents Association).
• Represent the department at local state and national meetings conferences and seminars.
• Coordinate and support stakeholder committees related to case management and service coordination.
• Work collaboratively with internal staff and state/local agencies.

Monitoring Reporting & Data Oversight

• Monitor cost and service data entered by CB/DDs and waiver providers to ensure accuracy.
• Track and respond to daily inquiries via email and phone.
• Provide follow-up assistance and conduct research to resolve system issues.
• Produce informational and management reports related to specialty areas for review and dissemination.

Other Duties

• Perform additional responsibilities as assigned to support department operations and initiatives.

Position requiring assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery requires current & valid license as registered nurse as issued by Ohio Board of Nursing pursuant to Sections 4723.03 & 4723.09 of Ohio revised code; additional 24 mos. nursing.

-Or for positions other than those requiring valid license as registered nurse completion of undergraduate core program in business administration social or behavioral science health or statistics; additional 24 mos. exp. specific to subject area of which 12 mos. use of spreadsheet and database software. Note: education & experience to be commensurate with approved position description on file.

-Or for positions other than those requiring valid license as registered nurse 24 months experience as Medicaid Health Systems Analyst (65291) may be substituted for the experience required but not for the mandated licensure.

-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: Health Administration Policy Direction Professional Regulatory Compliance

Professional Skills: Collaboration Attention to Detail Customer Focus Time Management

To request a reasonable accommodation due to disability please contact the ADA Coordinator by email at