HYBRID - Waiver Provider Oversight Specialist (Medicaid Health Systems

Schedule: Full-time

THIS POSITION WILL BE TELEWORK ELIGIBLE ON A HYBRID BASIS.

About Us:

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. ODM is implementing the next generation of Ohio Medicaid to fulfill its bold, new vision for Ohio’s Medicaid program - focusing on the individual rather than the business of managed care.

The goals of the next generation of Ohio Medicaid 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

What You Will Do at ODM:

Office: Operations

Bureau: Network Management

Classification: Medicaid Health Systems Specialist, PN 20046531

Job Preview:

As a Waiver Provider Oversight Specialist in the Bureau of Network Management, you will be responsible for the following:

· Issuing deficiency notices alert Home and Community Based Services (HCBS) waiver providers of Medicaid rule violations that must be corrected

· Monitoring compliance by evaluating Plans of Corrections

· Analyzing compliance history of former providers who are seeking re-enrollment as providers and determining if re-enrollment should be rejected

· Providing education on HCBS waiver provider Medicaid rules and best practices for compliance

· Preparing and delivering training, responding to inquiries

The preferred candidate has experience researching and operationalizing federal and state rules and regulations and strong analytical skills.

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.

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) may be substituted for the experience required.

-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