HYBRID - Non-Institutional Policy SDP Program Manager (Medicaid Health Systems Administrator 1)

What You Will Do at ODM:

Office: Policy

Bureau: Health Plan Policy

Classification: Medicaid Health Systems Administrator 1 (PN 20101958)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking an experienced healthcare administrator to be part of ODM's Non-Institutional Policy Team. As the Non-Institutional Policy Program Manager for State Directed Payments (SDPs) and supplemental ground ambulance provider payments, your responsibilities will include:

• researching federal and state regulations, current and previous policies, and applicable court cases in the formulation of Medicaid coverage and payment policies
• researching, analyzing, and evaluating the impact of federal and state regulations regarding the Medicaid program and all downstream applications and infrastructure
• developing and maintaining payment methodology models for each SDP and ensuring program compliance activities are maintained
• overseeing SDP program activities (e.g., Memorandum of Understandings [MOUs] for each SDP/provider, collection of Intergovernmental Transfers [IGTs])
• serving as the agency liaison and working collaboratively with stakeholders (e.g., Medicaid providers, managed care entities, sister state agencies and health related organizations) to develop Medicaid policies
• making recommendations regarding necessary legislative changes to support these policies

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 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, may be substituted for the experience required, but not for the mandated licensure, if required. Note: education & experience is to be commensurate with approved position description on file. -If position oversees assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery, incumbent must also have current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code.

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

Job Skills: Health Administration

Technical Skills: Public Health, Program Management, Technical Writing

Professional Skills: Collaboration, Organizing and Planning, Analyzation, Interpreting Data, Written Communication