The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. In 2020, ODM introduced a new vision for Ohio’s Medicaid program — one that strengthens Ohio’s future and ensures everyone has the chance to live life to its full potential.
Today, more than 90 percent of Ohio Medicaid members are supported by managed care organizations. During the year ahead, ODM will begin implementing a new vision for care; focusing on the individual, a strong partnership among MCOs and the department, and supporting specialization in addressing critical needs.
A program that puts the individual first
They Are
Adopting Governor DeWine’s philosophy of service to Ohioans, ODM embarked on an aggressive effort to redesign its managed care program. The goal is to provide more personal, holistic care and supports for millions of Ohioans served by Medicaid. Listening to feedback from more than 1,100 individuals and organizations we identified five procurement goals that would put the individual front and center of Medicaid’s program and policy decisions.
- Emphasize a personalized care experience,
- Improve care for children and adults with complex behavioral health needs,
- Improve wellness and health outcomes,
- Support providers in better patient care and
- Increase program transparency and accountability.
Unless required by legislation or union contract, starting salary will be set at step 1 of the pay range.
Working Title: Managed Care Contract Administrator
Classification: Medicaid Health Systems Administrator 1 (PN 20096540)
Office: Managed Care
Bureau: Managed Care Compliance & Oversight
Job Overview
As the Managed Care Contract Administrator 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 policy issues, implementations, and targeted reviews
- Working with the managed care plans to identify areas of concern
- Reviewing and approving policies
- Ensuring system updates are implemented timely and accurately, and providing technical assistance when required
- Communicating any compliance actions to the assigned Managed Care Plans
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 months experience 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 as a Medicaid Health Systems Specialist, 65293.
- Or equivalent of Minimum Class Qualifications for Employment noted above.
Primary Location
United States of America-OHIO-Franklin County-Columbus
Work Locations
Lazarus 4
Organization
Ohio Department of Medicaid
Classified Indicator
Classified
Bargaining Unit / Exempt
Exempt
Schedule
Full-time
Work Hours
8:00AM – 5:00PM
Compensation
$33.69/hour
Unposting Date
Dec 6, 2021, 11:59:00 PM
Job Function
Health Administration
Job Level
Individual Contributor
Agency Contact Information
HumanResources@medicaid.ohio.gov