MCO Training & Performance Manager (PN: 20067493)

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

BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

What Our Employees Have To Say

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

What You’ll Be Doing

• Leads the strategic development and delivery of comprehensive MCO policy training, ensuring contracted managed care organizations are equipped with clear, accurate, and consistently applied guidance that strengthens statewide program performance.
• Champions MCO policy compliance by conducting in‑depth research, drafting and refining policy within the MCO Policy Reference Guide, and overseeing effective implementation across all managed care organizations.
• Serves as a key operational partner to Medical Services and Compliance, representing the MCO Business Unit in cross‑functional Agency initiatives, workgroups, and high‑impact analyses to advance program quality, efficiency, and innovation.
• Leads comprehensive analysis and oversight of MCO performance by coordinating, interpreting, and evaluating key metrics and compliance outcomes, proactively identifying systemic trends, operational risks, and opportunities for improvement. This strategic insight informs refinements to policy, drives continuous improvement initiatives, and shapes targeted training interventions that strengthen statewide managed care performance and elevate service delivery across the Health Partnership Program.
• Communicates expertly and persuasively with senior leadership and external stakeholders, delivering high‑quality presentations to the Director, Chief, and managed care organizations to drive understanding, alignment, and accountability around MCO policy and compliance expectations

Certified medical coder in current procedural terminology (CPT) hospital coding, or current icd coding system; 12 mos. exp in writing medical policies & procedures for medical provider or insurance company; 12 mos. practical exp in health care field.

• Or completion of undergraduate program core coursework in pre-medicine, allied medical field, nursing or related field of study; 12 mos. practical exp. in health care field; 12 mos. exp. in writing medical policies & procedures for medical provider or insurance company.
• Or, completion of graduate core program in health care administration; 12 mos. exp. in medical policy development for medical provider or insurance company.
• Or equivalent of Minimum Class Qualifications for Employment noted above.

Job Skills:

Healthcare Administration

Major Worker Characteristics

Knowledge of:

employee training & development*; public speaking*; human relations*; BWC rules, policies & procedures*; MCOs*;EDI*, HPP*; BWC’s managed care vendor’s system*. power point and training software, statistical analysis, ICD 10 coding, medical terminology, BWC billing methodologies*.

Skill in:

personal computer; MS Software (e.g., Microsoft Office products including TEAMS) *.(PEACH provider database and document management system* BWC claims system*, Sharepoint* BWC billing system* OhioBWC.com*

Ability to:

manage variables & determine specific action; add, subtract, multiply & divide whole numbers; use statistical analysis; complete routine forms, maintain records, understand manuals & verbal instructions, technical in nature, use proper research methods in gathering data, prepare & deliver speeches before specialized audiences & general public. Ability to write technically correct and accurate reports, Draft training, job aids; ability to read, understand, analyze and interpret extensive variety of technical materials manuals, law books, CPT and HCPCS and ICD coding; gather, collate & classify information about data, people or things. Cooperate with co-workers on group projects.

• Developed after employment

Organization

Workers' Compensation

Work Location

William Green Building

Primary Location

United States of America-OHIO-Franklin County-Columbus

Compensation

$40.40/hr

Schedule

Full-time

Classified Indicator

Classified

Union

Exempt from Union

Primary Job Skill

Health Administration

Professional Skills

Attention to Detail, Ethics and Values, Time Management, Written Communication

Agency Overview

A Little About Us:

With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.

For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.

Our Culture

BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums and learn about how different perspectives can improve leadership skills.

Our Vision

To transform BWC into an agile organization driven by customer success.

Our Mission

To deliver consistently excellent experiences for each BWC customer every day.

Our Core Values

One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.

Agency Contact Name and Information

Sierra Dent - HCM Sr. Analyst: [e-mail]