The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. In 2020, ODM introduced a new vision for Ohio’s Medicaid program — one that strengthens Ohio’s future and ensures everyone has the chance to live life to its full potential.
Today, more than 90 percent of Ohio Medicaid members are supported by managed care organizations. During the year ahead, ODM will begin implementing a new vision for care; focusing on the individual, a strong partnership among MCOs and the department, and supporting specialization in addressing critical needs.
A program that puts the individual first
Adopting Governor DeWine’s philosophy of service to Ohioans, ODM embarked on an aggressive effort to redesign its managed care program. The goal is to provide more personal, holistic care and supports for millions of Ohioans served by Medicaid. Listening to feedback from more than 1,100 individuals and organizations we identified five procurement goals that would put the individual front and center of Medicaid’s program and policy decisions.
- Emphasize a personalized care experience,
- Improve care for children and adults with complex behavioral health needs,
- Improve wellness and health outcomes,
- Support providers in better patient care and
- Increase program transparency and accountability.
Unless required by legislation or union contract, starting salary will be set at step 1 of the pay range.
Office: Health Innovation & Quality
Bureau: Clinical Operations
Working Title: Medicaid Health Systems Administrator 2 (PN 20099227)
As the Incident Operations Manager in the Bureau of Clinical Operations, Ohio Department of Medicaid (ODM), your responsibilities will include:
- Developing and overseeing health and safety Incident requirements for Ohio Medicaid Waiver programs, Ohio Managed Care programs, and the OhioRISE program
- Planing, coordinating and ensuring appropriate program requirements and oversight activities are in place for the Medicaid Incident program
- Ensuring the health and safety of Ohio Medicaid members and compliance with state and Federal regulations
- Tracking business requirements and updates for the Ohio Medicaid Incident Management System (IMS)
- Evaluating data submitted to the IMS, to identify trends and patterns
- Serving as the Bureau of Clinical Operations Liaison with the MCO, MCO Waiver, and OhioRISE Incident Management Programs
- Making recommendations for program and operational changes as needed, and for sharing information about program performance with each external incident program to drive continuous improvement
- Reviewing, analyzing, and interpreting data (e.g., IMS data and oversight activity results) and reports, and provide recommendations for follow up activities related to program performance
- Working collaboratively with the supervisors in the Care Coordination Section as well as other internal and external stakeholders across a variety of departments, levels, and state agencies to conduct and develop review tools
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 24 months of 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.
- Or equivalent of Minimum Class Qualifications for Employment noted above.
United States of America-OHIO-Franklin County-Columbus
Ohio Department of Medicaid
Bargaining Unit / Exempt
Jul 23, 2021, 11:59:00 PM
Agency Contact Information
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