HYBRYD - Provider Network and Data Oversight Specialist (Health Services Policy Specialist)
Columbus, Ohio
Employer: Ohio Department of Aging
Industry: Classified
Salary: Competitive
Job type: Full-Time
What You Will Do At ODM:
Office : Managed Care
Bureau : Managed Care Compliance & Oversight
Classification: Medicaid Health Systems Administrator 1 (PN : 20102013 )
Job Overview:
As Provider Network and Data Oversight Specialist , your will be responsible to:
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:
Qualifications
Completion of graduate core coursework in health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics or comparable field; 2 yrs. exp. in health services research &/or health policy analysis; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 12 mos. trg. or 12 mos. exp. in use of computer programs/applications with emphasis on relational data bases, use of computer hardware, software used for spreadsheets, statistical analysis & graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.
-Or completion of undergraduate core coursework & 12 mos. exp. in one of following: health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics, public health, or comparable field; 2 yrs. exp. in health services research &/or health policy analysis; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 12 mos. trg. or 12 mos. exp. in use of computer programs/applications with emphasis on relational data bases, use of computer hardware, software used for spreadsheets, statistical analysis, graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.
-Or 2 yrs. exp. as Health Services Analyst, 65211.
-Or equivalent of Minimum Class Qualifications For Employment noted above.
Job Skills: Data Analytics
Technical Skills: Health Administration, Data Modeling, Data Visualization
Professional Skills: Analyzation, Attention to Detail, Collaboration, Innovation
Office : Managed Care
Bureau : Managed Care Compliance & Oversight
Classification: Medicaid Health Systems Administrator 1 (PN : 20102013 )
Job Overview:
As Provider Network and Data Oversight Specialist , your will be responsible to:
- Lead for managed care provider data management and provider network standard methodologies
- Manage provider network reporting for managed care organizations (MCOs)/ MyCare Ohio plans (MCOP)
- Assist with oversight of provider network management (PNM) module for Managed Care
- Assist in communication of data
- MCO/ MCOP provider enrollment liaison
- MCO/ MCOP lead for the managed care network provider reconciliation files
- Monitor Provider Agreement (PA)/ Code of Federal Regulations (CFR) Compliance
- Monitor and review MCO/ MCOP directories for compliance with PA (data specifically)
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 )
Qualifications
Completion of graduate core coursework in health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics or comparable field; 2 yrs. exp. in health services research &/or health policy analysis; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 12 mos. trg. or 12 mos. exp. in use of computer programs/applications with emphasis on relational data bases, use of computer hardware, software used for spreadsheets, statistical analysis & graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.
-Or completion of undergraduate core coursework & 12 mos. exp. in one of following: health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics, public health, or comparable field; 2 yrs. exp. in health services research &/or health policy analysis; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 12 mos. trg. or 12 mos. exp. in use of computer programs/applications with emphasis on relational data bases, use of computer hardware, software used for spreadsheets, statistical analysis, graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.
-Or 2 yrs. exp. as Health Services Analyst, 65211.
-Or equivalent of Minimum Class Qualifications For Employment noted above.
Job Skills: Data Analytics
Technical Skills: Health Administration, Data Modeling, Data Visualization
Professional Skills: Analyzation, Attention to Detail, Collaboration, Innovation
Created: 2024-09-07
Reference: 240008RY
Country: United States
State: Ohio
City: Columbus
ZIP: 43026