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Waiver Provider Supervisor (Medicaid Health Systems Administrator 1) at STATE OF OHIO

Posted in Management 21 days ago.

Type: Full-Time
Location: Columbus, Ohio





Job Description:

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

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. They are:


  • 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.

 

Office: Operations

Bureau: Network Management

Classification: Medicaid Health Systems Administrator 1 (PN 20087026)

 

Job Overview: 

As the Waiver Provider Supervisor in the Burau of Network Management, Ohio Department of Medicaid (ODM), your responsibilities will include:

 


  • Supervising staff responsible for managing Ohio Home Care Waiver provider oversight activities (developing and implementing training programs for compliance with Ohio Home Care rules, managing the annual Provider Oversight Structural reviews, identifying and analyzing deficiencies, reviewing and accepting/denying Plans of Correction)

  • Researching, evaluating, & analyzing state & federal legislation/regulations impacting Medicaid service delivery systems specifically for Home & Community Based Service waiver program

  • Responsibility for data analysis of information gathered from the reviews

  • Developing and creating comprehensive reports and performance standards for the structural review of contractors and for internal staff

  • Developing settlement agreements with ODM Legal when appropriate

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 as a Medicaid Health Systems Specialist, 65293.


Note: education & experience is to be commensurate with approved position description on file.

-Or equivalent of Minimum Class Qualifications for Employment noted above.