MCO Contract Control Audit Program Manager (PA3)

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.

EEO & ADA Statement:
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law state law and any effective executive order.

The Ohio Bureau of Workers Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable request reasonable accommodations related to a disability pregnancy or religion please contact the ADA mailbox

Salary Information:
Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months assuming job performance is acceptable. Thereafter an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.

Transportation:
Position may require travel; therefore persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.

Educational Transcripts:
For any educational achievements to be considered during the screening process you must at least attach an unofficial transcript that details the coursework you have completed.

All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.

Background Check:
Prior to an offer of employment the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.

BWCs core hours of operation are Monday-Friday from 8:00am to 5:00pm however daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWCs seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

What Youll Be Doing:

Position Overview:

The MCO Contract Control Program Managerplays a critical role in ensuring Managed Care Organizations (MCOs) meet all contractual regulatory and operational requirements. Under the direction of the Director of MCO Business Reporting this position leads the development and oversight of contract controls compliance monitoring and strategic initiatives that support the integrity and performance of the seven contracted managed care organizations (MCOs) working within Ohios Health Partnership program (HPP).

Key Responsibilities:

Policy Development Contract Compliance & Oversight

• Formulate and implement program policies to support the MCO Contract Control Risk and Compliance Management program.
• Lead the monitoring and enforcement of MCO contract controls (e.g. Business Continuity Plans cyber insurance AICPA SOC1/SOC2 compliance).
• Develop and implement policies and operational controls to ensure MCOs comply with contract terms and Ohio regulations.
• Develop the compliance strategy to mitigate Agency risks and track and report MCO compliance status timelines and violations to the Director and Medical Services Chief.
• Identify and document contract violations providing evidence-based reports to leadership and legal teams.

• Initiate and manage strategic projects to support program and policy development and management (e.g. SOC2 training AI-based continuity evaluations compliance tracking tools).
• Develop project plans metrics and presentation materials for internal governance and external stakeholders.
• Represent the Medical Services Division in cross-divisional and external collaborations.

Training & Communication

• Design and deliver internal and external training on MCO contract control programs.
• Serve as a representative on MCO Business Council subcommittees and workgroups.
• Act as a spokesperson for the Director and Division leadership at meetings and events.
• Assist in developing communication strategies for internal staff stakeholders and providers.

To Qualify You MustClearlyDemonstrate:

Required Experience and/or Education:

5 yrs. trg. or 5 yrs. business administration management or public administration.

-Or completion of undergraduate core program in business administration management or public administration; 36 mos. trg. or 36 mos. supervisory administrative &/or managerial position.

-Or completion of undergraduate core program for academic field of study commensurate with program area to be assigned per approved Position Description on File; 36 mos. trg. or 36 mos. supervisory administrative managerial &/or staff position involving planning research &/or policy/procedure development.

-Or 1 yr. exp. as Program Administrator 2 63123.

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

Prefer graduate level candidate including masters degree in business administration management health or public administration or law degree; or a bachelors degree in accounting or related field with contract management audit or compliance experience.

Job Skills: Program Management

MAJOR WORKER CHARACTERISTICS: Knowledge of business administration management science or public administration; supervisory principles/techniques; public relations; employee training & development; budgeting. Ability to define problems collect data establish facts & draw valid conclusions; develop complex reports & position papers; handle sensitive face-to-face contacts with public & government officials; establish friendly atmosphere as supervisor of work unit.

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.

A Little About Us:
With roughly 1500 employees in 7 offices across Ohio BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.
For Ohio employers we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.

Our Culture:
BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups participate in online forums discussing societys impact on our services and workplace and learn about how different perspectives can improve leadership skills.

Our Vision:
To transform BWC into an agile organization driven by customer success.

Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.

Our Core Values:
One Agency Personal Connection Innovative Leadership Relentless Excellence.

What our employees have to say:
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture helpfulness and acceptance Ive been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees their level of dedication to service pride in their work and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

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.