Non-Institutional Policy Program Manager (Medicaid Health Systems

Schedule: Full-time

What You Will Do at ODM:

Office: Policy

Bureau: Health Plan Policy

Classification: Medicaid Health Systems Administrator 1 (PN 20047472)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking an experienced healthcare administrator to be part of our Non-Institutional Policy Team. As a Non-Institutional Policy Program Manager, 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 statewide policies regarding coverage and payment for Medicaid covered services

managing critical budget initiatives and rule policy work for the following provider types:

Clinical laboratory providers, radiology imaging providers, transportation providers, and suppliers of durable medical equipment and supplies

serving as an 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 Medicaid policies

serving as a Subject Matter Expert (SME) on various workgroups and projects

assisting higher-level ODM administrators with the development and coordination of Medicaid policies

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