Eligibility Compliance Specialist (Medicaid Health Systems Specialist)

What You Will Do at ODM:

Office: Operations

Bureau: Business Operational Support

Classification: Medicaid Health Systems Specialist (PN 20037632)

Job Overview:

The Ohio Department of Medicaid is seeking an experienced professional to work in our Eligibility Compliance Unit. As a Medicaid Health Systems Specialist, your responsibilities will include:

Monitor eligibility determinations and processes of County Departments of Job and Family Services (CDJFS) to ensure compliance with Medicaid rules

Work with CDJFS to correct eligibility issues identified by business intelligence reporting and other Ohio Department of Medicaid work units

Monitor reports to assist in the administration of Medicaid eligibility (application timeliness, renewal timeliness, and change processing) and assist in the creation of new monitoring reports

Respond to inquiries from consumers, agency staff, stakeholders, and staff from other agencies

Work closely with CDJFS to complete corrective action plans The preferred candidate will have experience determining Medicaid eligibility, monitoring compliance with Medicaid eligibility rules, troubleshooting Medicaid eligibility issues, and be proficient in Microsoft Excel.

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

Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period

Paid time off, including vacation, personal, sick leave and 11 paid holidays per year

Childbirth, Adoption, and Foster Care leave

Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)

Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation ) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.

Qualifications

Completion of undergraduate core program in business administration, social or behavioral science, health or statistics; additional 24 months experience specific to subject area of which 12 months experience in use of spreadsheet and database software.

-Or 24 months experience as Medicaid Health Systems Analyst, (65291).

-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required.

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

Job Skills: Health Administration