Behavioral Health Policy Administrator (Medicaid Health Systems Administrator 1) in Columbus ,Ohio ,United States



Office: Policy

Bureau: Behavioral Health Policy

Classification: Medicaid Health Systems Administrator 1 (PN 20093477)

Job Preview:

The Ohio Department of Medicaid is seeking an experienced professional to be a part of our Behavioral Health Policy unit. As a Behavioral Health Policy Administrator, your responsibilities will include:

  • working alongside a team of dedicated staff engaged in policy development and implementation
  • assisting in the development and design of Medicaid Behavioral Health policies and initiatives
  • evaluating and directing organizational compliance of Behavioral Health policies
  • researching and analyzing the impact of state and federal legislation on Medicaid service delivery systems
  • coordinating and directing the implementation of Behavioral Health policy and compliance initiatives in the fee for service and managed care delivery systems
  • coordinating the review, preparation, clearance and filing of program rules, manuals and handbooks
  • ensuring that policies and procedures comply with federal and state regulations
  • participating in the coordination of policy development teams involving the delivery of services and access to care for individuals with behavioral health needs
  • assisting in the development of state plan amendments and communicating policy changes to the Centers for Medicare and Medicaid Services
  • providing technical assistance to managerial and supervisory personnel involved in the implementation of improvements or new programs

The preferred candidate will have a passion for learning, collaborating and contributing to the development of policies and programs that help improve the lives of Medicaid enrolled individuals with behavioral health conditions.

Job Description:

Under general direction, serves as agency manager of Medicaid program(s), &/or initiatives to research, analyze & evaluate the ongoing implementation of one statewide component of Medicaid health systems (i.e., substance use disorder services): Plans, manages, evaluates & directs organizational compliance of rules, policies & regulations related to behavioral health services (e.g. development & design of initiatives regarding Medicaid policies & procedures for substance use disorder services); directs & coordinates interoffice teams assisting with the organizational development & design of operational processes; researches, evaluates/analyzes state & federal legislation impacting Medicaid service delivery systems; monitors status of pending legislation; develops, drafts & defends program rules, policies, & procedures for delivery system; participates in the development of response to legislative issues; recommends legislative changes.

Coordinates & directs the implementation of departmental policy & compliance initiatives involving behavioral health policy; assists in the development & implementation of benefit plan policies & initiatives in both the fee for service & managed care delivery systems (e.g., initiatives which may include utilization management & care management strategies); coordinates review, preparation, clearance & filing of program rules, manuals & handbooks, ensures that policies & procedures comply with federal & state regulations by researching applicable regulations & working directly with appropriate federal & state agencies; participates in the coordination of policy development teams involving the delivery of services & access to care for consumers with behavioral health conditions; assists in the development of state plan amendments communicating policy changes to the Centers for Medicare & Medicaid Services (CMS) in order to receive federal matching funds for the Medicaid program(e.g., formulation & coordination of research documentation supporting the state plan amendment); advises supervisor regarding issues & problems; provides technical assistance to managerial & supervisory personnel involved in the implementation of improvements or new programs (e.g., researches & evaluates health care market developments & trends, analyzes value purchasing strategies involving fee for service & managed care delivery systems).

Prepares comprehensive written reports summarizing findings & recommendations of program policies; speaks to community groups, advocacy organizations, legal community, provider associations federal staff &/or public; responds in writing & verbally to sensitive inquiries & contacts from public, providers & government officials; provides assistance to teams to research, develop, analyze & evaluate strategic policies regarding the purchasing of services for Medicaid consumers (i.e., assists in the development & design of utilization management & quality assurance activities including the development & design of prior authorization of medical services for Medicaid consumers); writes requests for proposal & assists in the management of contractor activities).

Performs other related duties as assigned (attends staff meetings & training, coordinates & conducts public presentations, provides advice to public officials, maintains logs, records & files; travels to meeting sites).

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 as a 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 noted above.


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