Encounter Data Liaison (Medicaid Health Systems Administrator 2)

What You Will Do At ODM

Office: Data & Integrated Systems

Classification: Medicaid Health Systems Administrator 2 (PN 20045408)

Job Overview

The Ohio Department of Medicaid is seeking a healthcare professional to be part of our EDI & Encounters Team. This position serves as a technical and policy liaison for post-adjudication encounter data reporting submitted by managed care plans. Also, this position plays a critical role in ensuring data accuracy for rate setting, policy compliance, and quality care delivery.

As the Encounter Data Liaison, your responsibilities will include:

Developing policy, conducting program evaluation, and supporting data-driven decision-making.

Serving as the primary liaison for encounter data reporting and quality assurance.

Leading bi-weekly meetings with managed care organizations (MCOs) to discuss:

Delivery kick payments

Encounter data quality metrics

Quality-based assignments

New initiatives such as NexGen MyCare

Acting as the point person for the NexGen MyCare program launching 1/1/2026, coordinating across multiple departments.

Supporting rate setting, claims remittance investigations, and financial team collaboration.

Interpreting and communicating data trends and anomalies to internal and external stakeholders.

The following qualifications are not required, but are preferred for success in this role:

Familiarity with X12 formats (e.g. 837, PACDR 837, 835, 999, 824, 277CA, 270).

Proficiency in Medicaid data systems (i.e. MITS, Vue360, and/or Administrator).

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 24 months experience in planning & administering 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 analysis).

Or 24 months experience as a Medicaid Health Systems Administrator 1, 65295. Note: education & experience is to be commensurate with approved position description on file.

Or equivalent of Minimum Class Qualifications for Employment noted above.

Job Skills

Health Administration

Technical Skills

Public Health, Data Analytics

Professional Skills

Collaboration, Analysis, Interpreting Data, Attention to Detail

Organization

Medicaid

Agency Contact

Unposting Date

Nov 9, 2025, 11:59:00 PM

Work Location

Lazarus 5

Primary Location

United States of America-OHIO-Franklin County-Columbus

Compensation

$43.09/hour

Schedule

Full-time

Work Hours

8:00 am - 5:00 pm

Classified Indicator

Classified

Union

Exempt from Union

Primary Job Skill

Health Administration

Technical Skills

Data Analytics, Public Health

Professional Skills

Analyzation, Collaboration, Interpreting Data, Presenting

Agency Overview

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWines agenda for Ohios future. To ensure Ohio is the best place to live, work, raise and family and start a business, we must have strong schools, a great quality of life, and compassion for those who need our help. #J-18808-Ljbffr