MCO Training & Performance Manager

Schedule: Full-time

BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

What Our Employees Have to Say:

BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:

BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.

I have worked at several state agencies and BWC is the best place to work.

Best place to work in the state and with a sense of family and support.

I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.

I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application!

What You’ll Be Doing:

Leads the strategic development and delivery of comprehensive MCO policy training, ensuring contracted managed care organizations are equipped with clear, accurate, and consistently applied guidance that strengthens statewide program performance.

Champions MCO policy compliance by conducting in depth research, drafting and refining policy within the MCO Policy Reference Guide, and overseeing effective implementation across all managed care organizations.

Serves as a key operational partner to Medical Services and Compliance, representing the MCO Business Unit in cross functional Agency initiatives, workgroups, and high impact analyses to advance program quality, efficiency, and innovation.

Leads comprehensive analysis and oversight of MCO performance by coordinating, interpreting, and evaluating key metrics and compliance outcomes, proactively identifying systemic trends, operational risks, and opportunities for improvement. This strategic insight informs refinements to policy, drives continuous improvement initiatives, and shapes targeted training interventions that strengthen statewide managed care performance and elevate service delivery across the Health Partnership Program.

Communicates expertly and persuasively with senior leadership and external stakeholders, delivering high quality presentations to the Director, Chief, and managed care organizations to drive understanding, alignment, and accountability around MCO policy and compliance expectations

Certified medical coder in current procedural terminology (CPT) hospital coding, or current icd coding system; 12 mos. exp in writing medical policies & procedures for medical provider or insurance company; 12 mos. practical exp in health care field.

-Or completion of undergraduate program core coursework in pre-medicine, allied medical field, nursing or related field of study; 12 mos. practical exp. in health care field; 12 mos. exp. in writing medical policies & procedures for medical provider or insurance company.

-Or, completion of graduate core program in health care administration; 12 mos. exp. in medical policy development for medical provider or insurance company.

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

Job Skills: Healthcare Adminstration

Major Worker Characteristics:

Knowledge of: Knowledge of: employee training & development*; public speaking*; human relations*; BWC rules, policies & procedures*; MCOs*;EDI*, HPP*; BWC’s managed care vendor’s system*., power point and training software, statistical analysis, ICD 10 coding, medical terminology, BWC billing methodologies*.

Skill in: (25b) personal computer; MS Software (e.g., Microsoft Office products including TEAMS) *.(PEACH provider database and document management system* BWC claims system*, Sharepoint* BWC billing system* OhioBWC.com*

Ability to: manage variables & determine specific action; add, subtract, multiply & divide whole numbers; use statistical analysis; complete routine forms, maintain records, understand manuals & verbal instructions, technical in nature, use proper research methods in gathering data, prepare & deliver speeches before specialized audiences & general public. Ability to write technically correct and accurate reports, Draft training, job aids; ability to read, understand, analyze and interpret extensive variety of technical materials manuals, law books, CPT and HCPCS and ICD coding; gather, collate & classify information about data, people or things. Cooperate with co-workers on group projects.

* Developed after employment