Managed Care Contract & Compliance Lead

State of Ohio; Columbus (OH); On-site; USD 47,000 - 63,000; Full time

Benefits offered by this job

Medical Coverage

Dental and Vision Insurance

Paid time off

Education and Development Funds

Public Retirement Systems & Ohio DCF

Job summary

State of Ohio in Columbus seeks a Medicaid Health Systems Administrator (PN: 20046515) to manage contract information, conduct analyses, and lead on managed care contract issues. You will evaluate plans, support policy implementation, and coordinate with multiple MCOs and health plans.

The role emphasizes collaboration, confidentiality, and continuous improvement within an exempt, full-time position.

Qualifications

• Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance.
• 12 months experience in the delivery of a health services program or health services project management.

Responsibilities

• Managing program information and conducting analyses to inform and direct policy changes and updates
• Conducting evaluations for managed care plans
• Performing research and answering questions related to legislative and policy initiatives
• Leading on managed care related contract issues, implementations, and targeted reviews
• Working with the managed care plans to identify areas of concern and provide technical assistance as needed.
• Reviewing and approving submitted reports and deliverables outlined in the Managed Care Provider Agreements
• Communicating any compliance actions to the assigned Managed Care Plans

Skills

Health Administration

Collaboration

Verbal Communication

Written Communication

Confidentiality

Continuous Improvement

Innovation

Education

Graduate core program

Job description

State of Ohio in Columbus seeks a Medicaid Health Systems Administrator (PN: 20046515) to manage contract information, conduct analyses, and lead on managed care contract issues. You will evaluate plans, support policy implementation, and coordinate with multiple MCOs and health plans.

The role emphasizes collaboration, confidentiality, and continuous improvement within an exempt, full-time position.