HYBRID - Integrated Care Policy Specialist (Medicaid Health Systems Specialist)

What You Will Do at ODM:

Office: Policy

Bureau: Long Term Services & Supports

Classification: Medicaid Health Systems Specialist (PN 20046599)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking an experienced healthcare professional to join ODM's Integrated Care Policy Team. The Integrated Care Policy Team oversees programs within ODM concerned with streamlining the Medicare and Medicaid programs to the greatest extent possible for Ohioans who are enrolled in both programs (called dual-eligibles). By integrating the coverage and operations of these two health insurance programs, we aim to streamline care for dual-eligible Ohioans. This will involve reducing redundant administrative requirements and aligning Medicare and Medicaid policies regarding claims payment, member marketing materials, and appeal and grievances.

As an Integrated Care Policy Specialist, your responsibilities will include:

• enabling and monitoring access for MyCare plan staff to state Medicaid IT systems
• working with ODM data team to prepare and file federally required reports related to the MyCare Ohio program
• conducting policy and data research in conjunction with other ODM staff to answer inquiries from stakeholders and inform policy decisions
• monitoring operational procedures and utilization management data of the MyCare plans
• reviewing MyCare plan deliverables such as contractually required reports and fulfilled information requests from ODM
• responding to inquiries and requests from consumers, agency staff, stakeholders, and staff from other agencies

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 our Total 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.

Qualifications

-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. exp. in use of spreadsheet and database software. Note: education & experience to be commensurate with approved position description on file.

-Or 24 months experience as Medicaid Health Systems Analyst, (65291).

-Or equivalent of Minimum Class Qualifications for Employment.

Job Skills: Health Administration

Technical Skills: Public Health

Professional Skills: Customer Focus, Analyzation, Attention to Detail, Collaboration