Medicaid Program Manager Jobs in Ohio (NOW HIRING)

Organization: Medicaid

Agency Contact Name and Information: HumanResources@medicaid.ohio.gov

Unposting Date: Ongoing

Work Location: Lazarus 550 West Town Street Columbus 43215

Primary Location: United States of America-OHIO-Franklin County-Columbus

Compensation: Negotiable

Schedule: Full-time

Work Hours: 8:00 am - 5:00 pm

Classified Indicator: Unclassified

Union: Exempt from Union

Primary Job Skill: Medical

Technical Skills: Health Administration, Medical

Professional Skills: Collaboration, Decision Making, Delegation, Goal Setting, Innovation, Leading Others, Managing Meetings, Organizing and Planning, Performance Management, Priority Setting, Strategic Thinking, Confidentiality

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 a 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.

Job Description: What You Will Do At ODM:

Office: Health Innovation & Quality

Bureau: Health Innovation & Quality

Classification: Physician Administrator 2 (PN 20100458)

Job Overview: The Ohio Department of Medicaid (ODM) is recruiting for a Physician Administrator with significant clinical experience. As the Assistant Medicaid Medical Director, your duties will include:

• Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health equity, and other goals aimed at improving the quality of, and access to, services delivered to the Medicaid population
• Directing other agency/department staff/teams to implement utilization management and quality improvement policies, operations, and/or programs
• Providing leadership for cross-functional teams with clear communication, interpretation of shared data and structured processes to ensure consistency across different Medicaid populations and programs
• Developing and overseeing processes to ensure oversight of managed care organizations' adherence to provider agreement requirements, and state and federal regulatory requirements
• Ensuring policies and operations reflect industry standards for utilization management that can be applied to individual circumstances, using a person-centered, equity-focused approach
• Providing consultation on the application of structured quality improvement tools (e.g. Key Driver Diagrams and simplified Failure Effectiveness Mode Analyses to drive insights and improvements in health outcomes for varied Medicaid populations using a person-centered and equity focused approach
• Providing expertise of effective organizational and leadership skills to coach internal and external personnel, ensuring team progress in meeting agency goals

Why Work for the State of Ohio: 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.

Qualifications: Certificate to practice medicine in state of Ohio as issued by State Medical Board pursuant to Section 4731.14 & 4731.281 of Revised Code. Technical Skills: Medical Professional Skills: Collaboration, Goal Setting, Innovation, Leading Others, Managing Meetings, Organizing and Planning, Performance Management, Priority Setting, Decision Making, Delegation, Strategic Thinking

Supplemental Information: THIS POSITION IS OVERTIME EXEMPT. This position is unclassified per 124.11 (A) (9), Ohio Revised Code. 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.

ADA Statement: 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.

Drug-Free Workplace: 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.