LTC Rate Setting Manager | Policy & Analytics Lead

State of Ohio; Columbus (OH); On-site; USD 55,000 - 56,000; Full time

Benefits offered by this job

Medical Coverage

Dental and Vision Insurance

Paid time off and holidays

Education and development funds

Public retirement systems

Job summary

The State of Ohio’s Medicaid department seeks an experienced Long-Term Care Rate Setting Manager to lead the Nursing Facility (NF) LTC rate setting team in developing, maintaining and analyzing NF reimbursement rates. You will oversee rate development and the analytical, operational, and policy work that supports Ohio’s NF reimbursement program.

As NF LTC Rate Setting Manager, you will develop semi-annual NF rates, manage rate adjustments, perform data analysis on NF claims and cost reports,

Qualifications

• Graduate-level program in business, management or public administration, public health, health administration, or related field.
• 12 months of health services program delivery or health services project management experience.

Responsibilities

• Develop semi-annual long-term care rate updates and manage rate adjustments.
• Perform data analysis of NF claims, cost reports, franchise permit fee, and upper payment limit calculations.
• Maintain NF rate setting components within OMES (Ohio Medicaid Enterprise System).
• Review legislative proposals, inquiries, statutes, and rules related to NF rates and provide cost estimates and budget projections.
• Collaborate with Policy, Budget, Data Governance, Fiscal, Franchise Permit Fee, and LTC Enrollment teams to ensure alignment on rate initiatives.
• Manage the NF Private Room Incentive Program (rule review, approvals/denials, attestations, monitoring).
• Monitor NF enrollment, MDS trends, cost report patterns, Medicaid days, licensed beds, and related data for projections.
• Respond to inquiries from NF associations, managed care plans, and providers regarding NF rates.

Skills

Health Administration

Program Management

Public Health

Collaboration

Critical Thinking

Innovation

Problem Solving

Education

Graduate core program in business/public administration/public health/health administration

12 months health services program/project management experience

Job description

The State of Ohio’s Medicaid department seeks an experienced Long-Term Care Rate Setting Manager to lead the Nursing Facility (NF) LTC rate setting team in developing, maintaining and analyzing NF reimbursement rates. You will oversee rate development and the analytical, operational, and policy work that supports Ohio’s NF reimbursement program.

As NF LTC Rate Setting Manager, you will develop semi-annual NF rates, manage rate adjustments, perform data analysis on NF claims and cost reports,