MCO Policy & Performance Training Lead

Ohio BWC (official); Columbus (OH); On-site; USD 55,000 - 69,000; Full time

Job summary

Bureau of Workers' Compensation (BWC) in Ohio seeks a qualified professional to lead policy training for managed care organizations and ensure consistent guidance across the statewide program. The role supports Medical Services and Compliance in cross-functional initiatives and policy implementation to elevate service delivery.

The ideal candidate has experience drafting medical policy, familiarity with CPT/HCPCS/ ICD coding, and strong communication skills to present to leadership and external

Qualifications

• 12 mos. exp in writing medical policies & procedures for medical provider or insurance company.
• Experience with CPT/HCPCS ICD coding.
• Understanding of health care policy development processes.
• Strong written and verbal communication skills.

Responsibilities

• Leads strategic development and delivery of comprehensive MCO policy training.
• Oversees policy compliance and implementation across managed care organizations.
• Partners with Medical Services and Compliance in cross-functional Agency initiatives.
• Analyzes MCO performance metrics and identifies risks and improvement opportunities.
• Delivers presentations to senior leadership and external stakeholders.

Skills

Healthcare Administration

Policy development

Public speaking

Data analysis

Education

Undergraduate health-related coursework

Graduate health care administration program

Minimum Class Qualifications for Employment

Tools

SharePoint

BWC claims system

PowerPoint

ICD/HCPCS knowledge

Job description

Bureau of Workers' Compensation (BWC) in Ohio seeks a qualified professional to lead policy training for managed care organizations and ensure consistent guidance across the statewide program. The role supports Medical Services and Compliance in cross-functional initiatives and policy implementation to elevate service delivery.

The ideal candidate has experience drafting medical policy, familiarity with CPT/HCPCS/ ICD coding, and strong communication skills to present to leadership and external