IO Program Coordinator II

State of Oklahoma; Oklahoma City (OK); On-site; USD 47,000 - 51,000; Full time

Benefits offered by this job

Health insurance

Retirement savings plan

Paid holidays

Vacation and sick leave

Job summary

State of Oklahoma's Oklahoma Health Care Authority (OHCA) seeks an IO Program Coordinator II to support SoonerCare/Insure Oklahoma and other Medicaid programs. You will resolve member, employer, and agent inquiries, manage enrollments, process invoices and documents, and ensure policy compliance.

The role requires strong communication, attention to detail, and the ability to navigate complex program guidelines, with responsibilities including eligibility processing, system updates, and liaison

Qualifications

• 1 year of experience as a customer service representative.
• Equivalent combination of education and experience.
• Certifications in related areas are preferred.

Responsibilities

• Resolve employer, agent and member inquiries and complaints.
• Investigate and address employer payment discrepancies, fraud and abuse, and quality assurance issues.
• Interpret and communicate SoonerCare/Insure Oklahoma policies to employers, members, and stakeholders.
• Educate on program coverage, services, and eligibility guidelines for SoonerCare and Insure Oklahoma.
• Process and resolve eligibility issues, payment discrepancies and invoice discrepancies.
• Manage member applications, enrollments, plan changes, and eligibility verifications.
• Identify and report system discrepancies and research system updates and corrections.
• Stay current on program rule revisions and changes; update reference materials.

Skills

Customer service

Communication skills

Attention to detail

Problem solving

Job description

Job Posting Title

IO Program Coordinator II

Agency

807 HEALTH CARE AUTHORITY

Supervisory Organization

Eligibility & Coverage Service

Full/Part-Time

Full time

Job Type

Regular

Compensation

22.81875 / hour

Why You’ll Love Working Here

At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values, Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership , we foster a workplace where people feel supported, respected, and empowered to make an impact. Learn more about OHCA.

Let’s Talk Benefits

We know your great work deserves great support. Here’s a snapshot of what we offer for all eligible employees.

• Generous state-paid benefit allowance to offset insurance premiums.

• A wide selection of insurance plans with no pre-existing condition exclusions.

• Flexible Spending Accounts for health care and dependent care.

• Retirement Savings Plan with employer contributions.

• 11 paid holidays annually.

• 15 days of vacation and 15 days of sick leave in the first year.

• Longevity Bonus recognizing years of public service.

• Public Service Loan Forgiveness eligibility and tuition reimbursement.

• Wellness benefits, including an on-site gym and fitness center discounts.

Job Description

Location: 4345 N Lincoln Blvd, Oklahoma City, OK 73105

Salary: 22.81875 / hour

Work Schedule: Monday – Friday

Primary Hours: 8:00 a.m. – 5:00 p.m.

Agency/Division Information

The Oklahoma Health Care Authority (OHCA)works to ensure Oklahomans have access to better health and better care.The agency’s core values include passion for purpose, trust and transparency,empowermentand accountability, best in class and outcome-driven, and servant leadership.As part of the interview process, candidates maybe requiredto attend an in-person interview at our Oklahoma City office.

Position Purpose

IO Program Coordinator IIplays a critical role in supporting the Oklahoma Health Care Authority’s mission by ensuring efficient and effective administration ofSoonerCare/Insure Oklahomaand other Medicaid programs. This positionis responsible forresolving member,employerand agent inquiries,managing member enrollments,processing invoices and employer documents, processing incomedocumentsand maintaining compliance with program policies. The role requiresstrong communicationskills, attention to detail, and the ability to navigate complex program guidelines, all whilemaintaininga high standard of service to internal and external stakeholders.

Principal Activities May Include:

• Research and resolveemployer, agent andmember inquiriesandcomplaints.

• Investigate and addressemployer payment discrepancies, fraud andabuse, and quality assurance complaints.

• Interpret and communicateSoonerCare/Insure Oklahomapolicies and procedures toemployers,members, and stakeholders.

• Educate on program coverage, services, and eligibility guidelines forSoonerCare, and InsureOklahomaprograms.

• Process and resolveeligibility issues, paymentdiscrepanciesand invoice discrepancies.

• Manage member applications, enrollments, plan changes, and eligibility verifications.

• Identifyand report system discrepancies.

• Research and implement system updates and corrections.

• Stay current onSoonerCare/Insure Oklahomarule revisions and program changes.

• Maintain organized reference materials and update written controls.

• Coordinate with other departments on operational procedures.

• Communicate independently with members,employersand stakeholders to resolve issues.

• Participate in special projects, memberand employeroutreach, and educational efforts.

• RepresentsOHCA in meetings, seminars, and training forums.

• Support workflow during staff absences and manage high call volumes.

• Other duties as assigned.

Qualifications: To perform this job successfully, an individual must be able to perform eachessential duty satisfactorily. The requirements listed below are representative of the knowledge,skill, and/or abilityrequired.

Knowledge, Skills, Abilities and Competency Requirements

IO Program Coordinator IIrequiresin-depth knowledge of Medicaid program policies,strong communicationskills for resolving inquiries, and the ability to manage complex administrative processes. This role demands attention to detail, effective collaboration, and the ability to navigate both member andemployerconcerns. The Korn Ferry competencies that align well with this position are Manages Complexity , for handling detailed program and policy administration, and Collaborates , for working effectively with both internal and external stakeholders to resolve issues and ensure program success.

**To be considered for this position your application must include a resume/CV with complete work and education history.**

Education and/or Experience:

• 1 year of experienceas customer service representative.

• An equivalent combination of education and experience, substituting thirty semester hours of college, including six semester hours in business or public administration for the required experience plus1years of experience in customer service, processing tax returns, bookkeeping or closely related work.

Preference Qualifications Include:

• Certifications in any of the following areas:Certified Medicaid Professional (CMP), Customer Service or Call Center Management Certification, Project Management Certification (PMP), Lean Six Sigma Certification, Certified Health Data Analyst (CHDA), or Health Insurance Portability and Accountability Act (HIPAA) Certification

Physical Demands and Work Environment

Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels.In the course ofperforming job duties, employeesare required tospeak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.

Accommodation Statement

The Oklahoma Health Care Authoritycomplies withapplicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. Ifa reasonableaccommodation is needed toparticipatein the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.