What You Will Do at ODM:
Office: Policy
Bureau: Health Plan Policy
Classification: Medicaid Health Systems Administrator 1 (PN 20090339)
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 such as those concerning provider agreements and credentialing, payment, coordination of benefits, program integrity, alternative payment models, 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:
* oversight of ODM's Telehealth policy and others as assigned including updates to Ohio Administrative Code (OAC), Medicaid state plan, and Medicaid Management Information System (MMIS)
* evaluating & assessing program needs & 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 & state regulations, rules & laws
* evaluating and analyzing policies related to the design and regulatory oversight of general Medicaid provisions
* 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 programs and policies
* responding to inquiries from internal and external stakeholders
The preferred candidate will have experience researching state/federal laws or regulations as well as 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. exp. in 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. Note: education & experience is to be commensurate with approved position description on file.
* Or equivalent of Minimum Class Qualifications for Employment.
Job Skills: Health Administration
Technical Skills: Public Health
Professional Skills: Collaboration, Attention to Detail, Analyzation, Innovation, Written Communication