Medicaid Health Systems Specialist

Schedule: Full-time

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Accepting applications for:

Medicaid Health Systems Specialist

What will you do?

The Medicaid Health Systems Specialist serves as a key team member responsible for reviewing, coordinating, and responding to inquiries regarding services and supports through a formalized statewide communication system. This position plays a central role in supporting system innovation, policy interpretation, and technical assistance related to Medicaid services for individuals with developmental disabilities.

Communication & Coordination

Review, coordinate, and respond to inquiries related to services and supports via a statewide communication system

Compose and manage responses to correspondence and field inquiries.

Provide information to constituents, individuals with developmental disabilities (DD), families, healthcare providers, county boards of DD (CB/DD), associations, and government agencies.

Ensure health, safety, service quality, and satisfaction through clear and accurate communication.

Policy, Program & System Support

Assist in developing and implementing Medicaid policy, goals, and objectives for departmental programs and initiatives.

Design systems and procedures to assess program outcomes.

Provide data and narrative components for biennial budget requests.

Support system innovations and technical assistance related to statewide Medicaid services, grants, interagency agreements, and self-determination efforts.

Participate in rule and statute review, revision, and promulgation.

Respond to and assist with requests for waivers of Ohio Administrative Code requirements.

Training & Technical Assistance

Provide interpretation, guidance, and implementation support for Medicaid rules, regulations, and policies.

Deliver training sessions, webinars, and statewide or regional activities to ensure consistent policy application.

Collaborate with team members to develop training content for all components of the Medicaid Service System (MSS).

Offer daily system assistance to the field, including CB/DDs, providers, individuals, families, and advocates.

Systems & Technology

Utilize and support field use of key systems including:

Medicaid Information Technology System (MITS)

Imagine365 CRM

Other required technology platforms

Review documents for accuracy, clarity, and professional presentation.

Develop materials and presentations for training, technical assistance, and publication.

Participate in system development, testing, feedback, implementation, and recommendations for improvement.

Stakeholder Engagement & Representation

Act as liaison to regional organizations (e.g., Ohio Association of Adult Services, Ohio Superintendent’s Association).

Represent the department at local, state, and national meetings, conferences, and seminars.

Coordinate and support stakeholder committees related to case management and service coordination.

Work collaboratively with internal staff and state/local agencies.

Monitoring, Reporting & Data Oversight

Monitor cost and service data entered by CB/DDs and waiver providers to ensure accuracy.

Track and respond to daily inquiries via email and phone.

Provide follow-up assistance and conduct research to resolve system issues.

Produce informational and management reports related to specialty areas for review and dissemination.

Other Duties

Perform additional responsibilities as assigned to support department operations and initiatives.

Position requiring assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery requires current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03 & 4723.09 of Ohio revised code; additional 24 mos. exp. in nursing.

-Or for positions other than those requiring valid license as registered nurse, completion of undergraduate core program in business administration, social or behavioral science, health or statistics; additional 24 mos. exp. specific to subject area of which 12 mos. exp. in use of spreadsheet and database software. Note: education & experience to be commensurate with approved position description on file.

-Or for positions other than those requiring valid license as registered nurse, 24 months experience as Medicaid Health Systems Analyst, (65291) may be substituted for the experience required, but not for the mandated licensure.

-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: Health Administration, Policy Direction, Professional, Regulatory Compliance

Professional Skills: Collaboration, Attention to Detail, Customer Focus, Time Management

To request a reasonable accommodation due to disability, please contact the ADA Coordinator by email at .