Performance Improvement Manager - PN 20099235 (Medicaid Health Systems Administrator 1)

State of Ohio; Columbus (OH); Vor Ort; USD 46.000 - 65.000; Vollzeit

Zusammenfassung

The Ohio Department of Medicaid, Health Innovation & Quality, seeks a Performance Improvement Manager to lead quality improvement initiatives across Medicaid populations, focusing on Children with Chronic Conditions. You will design QIPs, coordinate data analysis, and ensure compliance with CMS and state regulations.

Reporting to the Health Innovation & Quality team, the role involves managing projects, coordinating measures, and guiding contracted staff to improve population health outcomes in

Qualifikationen

• Graduate core program in business, public administration, public health or health administration.

Aufgaben

• Manage development, implementation and reporting of quality improvement projects for targeted Medicaid populations.
• Direct design of QIPs for Children with Chronic Conditions to improve outcomes and care transitions.
• Direct and/or conduct research on evidence-based interventions for QIP topics.
• Coordinate identification of quality measures and data analysis for OhioRISE QIPs.
• Develop methodology and timeline for monitoring and evaluating QIPs with outcome measurement.
• Review CMS rules and state regulations to ensure compliance.
• Manage contracted consultant staff supporting PIHP quality initiatives.
• Formulate policy recommendations and legislative changes for QIPs.

Kenntnisse

Health Administration

Jobbeschreibung

Organization: Medicaid

Agency Contact Name and Information: [e-mail]

Work Location: 50 West Town Street
Columbus, Ohio, 43215
United States

Compensation: $40.40

Schedule: Permanent - Full Time

Work Hours: 8:00AM - 5:00PM

Classified Indicator: Classified

Union: Exempt from union

Primary Job Skill: Health Administration

Who We Are

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help.
Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:

• Delivering a personalized care experience to more than three million people served.
• Improving care for children and adults with complex behavioral health needs.
• Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.
• Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.
• Ensuring financial transparency and operational accountability across all Medicaid programs and services.

What You’ll Do

Office: Health Innovation & Quality
Bureau: Health Research & Quality
Classification: Medicaid Health Systems Administrator 1 (PN: 20099235)

Job Overview:

The Performance Improvement Manager is an integral part of the Ohio Department of Medicaid's (ODM's) Health Innovation & Quality team. As Performance Improvement Manager, your responsibilities will include:

• Managing the development, implementation, and reporting of quality improvement projects (QIPs) for targeted Medicaid populations (i.e. Children with Chronic Conditions)
• Directing the design of Children with Chronic Conditions QIPs, to include (but not limited to) a focus on improving disparate outcomes and improvement of care transitions for consumers with specific disease conditions
• Directing and/or conducting research evidence-based interventions/strategies for Children with Chronic Conditions QIP topics
• Coordinating the identification of applicable quality measures and the collection and analysis of health services data to support the design and evaluation of Children with Chronic Conditions QIPs for the OhioRISE Plan
• Developing a methodology and implementation timeline for monitoring and evaluating Children with Chronic Conditions QIPs, including outcome measurement and impact on population health
• Reviewing applicable rules, policies, laws and guidelines to ensure compliance with Centers for Medicare and Medicaid Services (CMS) rules & regulations, as well as all applicable state regulations, rules and laws
• Managing and directing contracted consultant staff and services supporting the design, development, implementation, evaluation and reporting related to the quality improvement initiatives for the PIHP
• Formulating policy and recommending legislative changes for Children with Chronic Conditions QIPs.

Additional Information

The Ohio Department of Medicaid does not provide employment-based visa sponsorship.

Compensation is as listed on the posting unless required by legislation or union contract.

The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full-time, if selected.

Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.

Why Work for the State of Ohio

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
• Public Retirement Systems such as OPERS, STRS, SERS, and HPRS & Optional Deferred Compensation Ohio Deferred Compensation

*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this 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 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise health services program communication health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).

-Or 12 months experience has Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure, if required. Note: education & experience is to be commensurate with approved position description on file. -If position oversees assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery, incumbent must also have current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code.

-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.

Job Skills: Health Administration

ADA Statement

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

Drug-Free Workplace

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.