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SUN Behavioral Columbus

Financial Counselor

Columbus, OH

$18 - $23.50/hr

Verify all active clients Medicaid and Medicaid HMO on the first of each month * Assist patients with filing for financial assistance. * Follow-up on in-house payment plans effectively * Perform data ...

Astreya

Project & Program Management II

New Albany, OH · On-site

$66K - $104K/yr

Medical provided throughUHC(PPO, HSA,Surestoptions) / Medical provided through Kaiser (HMO option only) for California employees only * Dental provided throughUHC * Nationwide Vision provided byUHC

SUN Behavioral Columbus

Financial Counselor

Columbus, OH · On-site

$18 - $23.50/hr

Verify all active clients Medicaid and Medicaid HMO on the first of each month * Assist patients with filing for financial assistance. * Follow-up on in-house payment plans effectively * Perform data ...

Astreya

Data Center Technician III

New Albany, OH · On-site

$28.76 - $45.40/hr

Medical provided throughUHC(PPO, HSA,Surestoptions) / Medical provided through Kaiser (HMO option only) for California employees only * Dental provided throughUHC * Nationwide Vision provided byUHC

Astreya

Project & Program Management II

New Albany, OH · On-site

$66 - $104/hr

Medical provided through UHC (PPO, HSA, Surest options) / Medical provided through Kaiser (HMO option only) for California employees only* Dental provided through UHC* Nationwide Vision provided by ...

Astreya

Project & Program Management II

New Albany, OH · On-site

$66K - $104K/yr

Medical provided through UHC (PPO, HSA, Surest options) / Medical provided through Kaiser (HMO option only) for California employees only * Dental provided through UHC * Nationwide Vision provided by ...

Astreya

Data Center Technician III

New Albany, OH · On-site

$28.76 - $45.40/hr

Medical provided through UHC (PPO, HSA, Surest options) / Medical provided through Kaiser (HMO option only) for California employees only * Dental provided through UHC * Nationwide Vision provided by ...

Accendra Health

Sleep Coach

Columbus, OH · On-site

$19 - $25/hr

Experience with various insurance plans (HMO, PPO, Medicare) SKILLS, KNOWLEDGE AND ABILITIES * Patient-Focused: You start with the patient and work backwards. You invest the time and energy to ...

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A map of the United States highlighting the number of Hmo job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Hmo job openings in each state, with California having the most at 2 and Hawaii the least at 0.

Encounter Data Liaison (Medicaid Health Systems Administrator 2)

Ohio Department of Taxation

Columbus, OH

Full-time

Posted 13 days ago

Job description

What You Will Do at ODM:

Office: Data & Integrated Systems

Classification: Medicaid Health Systems Administrator 2 (PN 20102830)

Job Overview:

The Ohio Department of Medicaid is seeking a healthcare professional to be part of our EDI & Encounters Team. This position serves as a technical and policy liaison for post-adjudication encounter data reporting submitted by managed care plans. Also, this position plays a critical role in ensuring data accuracy for rate setting, policy compliance, and quality care delivery. As the Encounter Data Liaison, your responsibilities will include:

  • Developing policy, conducting program evaluation, and supporting data-driven decision-making.
  • Serving as the primary liaison for encounter data reporting and quality assurance.
  • Leading bi-weekly meetings with managed care organizations (MCOs) to discuss: 
    • Delivery kick payments
    • Encounter data quality metrics
    • Quality-based assignments
    • New initiatives such as NexGen MyCare
  • Acting as the point person for the NexGen MyCare program launched 1/1/2026, coordinating across multiple departments.
  • Supporting rate setting, claims remittance investigations, and financial team collaboration.

  • Interpreting and communicating data trends and anomalies to internal and external stakeholders.

The following qualifications are not required, but are preferred for success in this role:

  • Familiarity with X12 formats (e.g. 837, PACDR 837, 835, 999, 824, 277CA, 270).

  • Proficiency in Medicaid data systems (i.e. MITS, Vue360, and/or Administrator).

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 24 mos. exp. 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. Note: education & experience is to be commensurate with approved position description on file.

-Or equivalent of Minimum Class Qualifications for Employment noted above.

Job Skills: Health Administration

Technical Skills: Public Health, Data Analytics

Professional Skills: Collaboration, Analyzation, Interpreting Data, Attention to Detail

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