Medicaid Eligibility Quality Analyst

Taleo; Columbus (OH); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical Coverage

Paid time off

Education opportunities

Public retirement benefits

Job summary

Ohio Department of Medicaid seeks a Medicaid Quality Control Analyst to join the Eligibility Quality Control unit. You will perform quality reviews of Medicaid eligibility determinations made by county agencies to ensure timeliness and accuracy statewide.

The role requires strong analytical skills, attention to detail, and experience with Medicaid programs. Full-time position in Columbus with comprehensive state benefits and union representation.

Qualifications

• Undergraduate coursework in social and/or behavioral science; 12 months’ training or experience in public assistance regulations and policies.
• 3 months’ training or 3 months’ experience in technical writing; 3 months’ training or 3 months’ experience in mainframe databases; valid Ohio driver’s license.
• Equivalent minimum qualifications for employment.

Responsibilities

• Conduct comprehensive case reviews of county CDJFS records to determine Medicaid eligibility.
• Review approvals/denials of randomly selected CHIP and Medicaid cases for accuracy.
• Analyze automated systems to ensure compliance with federal and state rules.
• Verify all aspects of eligibility by reviewing records, verifications, and system actions.
• Provide final determinations and communicate results and analysis of reviews.

Skills

Health Administration

Attention to Detail

Collaboration

Interpreting Data

Results Oriented

Verbal Communication

Written Communication

Job description

Ohio Department of Medicaid seeks a Medicaid Quality Control Analyst to join the Eligibility Quality Control unit. You will perform quality reviews of Medicaid eligibility determinations made by county agencies to ensure timeliness and accuracy statewide.

The role requires strong analytical skills, attention to detail, and experience with Medicaid programs. Full-time position in Columbus with comprehensive state benefits and union representation.