HYBRID - Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

What You Will Do At ODM:

Office : Managed Care

Bureau : Managed Care Compliance & Oversight

Classification : Medicaid Health Systems Administrator 1 (PN 20100146 )

Job Overview :

As the Managed Care Contract Manager 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

There are 5 MyCare Plans and 7 Managed Care Organizations (MCOs) that you will be working with.

MyCare Plans:

• Aetna Better Health of Ohio, Inc.

• Buckeye Health Plan

• CareSource

• Molina HealthCare of Ohio, Inc.

• UnitedHealthcare Community Plan

Managed Care Organizations (MCOs)

• AmeriHealth Caritas Ohio, Inc.

• Anthem Blue Cross and Blue Shield

• Buckeye Health Plan

• CareSource

• Humana Healthy Horizons in Ohio

• Molina HealthCare of Ohio, Inc.

• UnitedHealthcare Community Plan

What's in it for you:

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

• Quality, affordable, and competitive medical benefits are offered through the available Ohio Med plans.

Dental, Vision and Basic Life Insurance

• Dental, vision, and basic life insurance premiums are free after completed eligibility period . Length of eligibility period is dependent on union representation.

Time Away From Work and Work/Life Balance

• Paid time off, including vacation, personal, and sick leave
• 11 paid holidays per year
• Childbirth/Adoption leave

Employee Development Funds

• The State of Ohio offers a variety of educational and professional development funding that varies based on whether you are a union-exempt employee or a union-represented employee.

Ohio Public Employees Retirement System

• OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee's salary. Visit the OPERS website for more information.

Deferred Compensation

• The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.

Qualifications

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,

-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.

Technical Skills: Health Administration

Professional Skills: Collaboration, Decision Making, Leading Others, Managing Meetings, Motivating Others, Performance Management, Time Management, Verbal Communication, Written Communication