HYBRID - Provider Oversight Specialist

THIS POSITION WILL BE TELEWORK ELIGIBLE ON A HYBRID BASIS.

About Us:

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. ODM is implementing the next generation of Ohio Medicaid to fulfill its bold, new vision for Ohio’s Medicaid program - focusing on the individual rather than the business of managed care.

The goals of the next generation of Ohio Medicaid are:

• 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

What You Will Do at ODM:

Office: Operations

Bureau: Network Management

Classification: Medicaid Health Systems Specialist, PN 20046549

Job Preview:

As a Waiver Provider Oversight Specialist in the Bureau of Network Management, your responsibilities will include the following activities:

• Issue deficiency notices and alert Home and Community Based Services (HCBS) waiver providers of Medicaid rule violations that must be corrected
• Monitor compliance by evaluating Plans of Corrections
• Analyze compliance history of former providers who seek re-enrollment and determine if re-enrollment should be rejected
• Provide technical support to consumers and external stakeholders on HCBS waiver provider Medicaid rules and best practices for compliance
• Prepare and deliver training, respond to inquiries

The preferred candidate should have experience researching and operationalizing federal and state rules and regulations and strong critical thinking skills.

What’s in it for you:

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

• Quality, affordable, and competitive medical benefits are offered through the Ohio Med PPO plan.

Dental, Vision and Basic Life Insurance

• Dental, vision and basic life insurance premiums are free after one year of continuous service.

Time Away From Work and Work/Life Balance

• Paid time off, including vacation, personal, and sick leave
• 11 paid holidays per year
• Childbirth/Adoption leave

Ohio Public Employees Retirement System

• OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee’s salary. Visit the OPERS website for more information.

Deferred Compensation

• The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.

• 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.

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

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.

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.