Care Coordination Oversight Manager (Medicaid Health Systems

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

About Us:

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 DeWine’s agenda for Ohio’s 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.

Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:

Delivering a personalized care experience to more than three million people served.

Improving care for children and adults with complex behavioral health needs.

Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.

Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.

Ensuring financial transparency and operational accountability across all Medicaid programs and services.

Compensation is as listed on the posting unless required by legislation or union contract.

This position is overtime exempt.

Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.

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.

What You Will Do at ODM:

Office: Policy

Bureau: Long Term Services & Supports

Classification: Medicaid Health Systems Administrator 1 (PN 20087324)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking a healthcare professional to be part of our Managed Care Care Coordination Team. This position will provide care coordination oversight for the following Managed Care Organizations (MCOs):

UnitedHealthcare

Humana Healthy Horizons

As a Care Coordination Oversight Manager, your responsibilities will include:

Overseeing and monitoring care coordination delivery services provided by ODM's MCOs.

Providing oversight in the development of innovative program initiatives designed to improve access to health services.

Overseeing the coordination of policy and program planning by researching delivery systems within a population health model and providing feedback on findings.

Reviewing, analyzing, and interpreting data (e.g. analysis data collected from consumer surveys) and reports and providing recommendations for follow up activities related to performance.

Overseeing external quality review activities, including the development of administrative reports.

Working collaboratively with internal and external stakeholders across a variety of departments, levels, state agencies, and MCOs to improve care coordination for the individuals served by ODM.

Preferable licensure for this position is\: Licensed Social Worker, Licensed Professional Counselor, Registered Nurse, or Licensed Allied Health Professional

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

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

-Or equivalent of Minimum Class Qualifications for Employment.

Job Skills: Health Administration

Technical Skills: Public Health, Program Management

Professional Skills: Collaboration, Goal Setting, Analyzation, Performance Management