Medicaid Health Systems Administrator 3

Job Duties :

• Uses clinical background and expertise to serve as Agency Manager of clinical Waiver Program areas to include : nursing, level of care, PASRR, & Prior Authorization Program.
• Works with all stakeholders, stakeholder liaisons & department representatives on service planning, assessments, waiting lists, & other key Medicaid services that impact multiple components within & outside the agency (e.g., other state departments, county boards of developmental disabilities, families, guardians, etc.).
• Conducts detailed research analysis of all Medicaid Waiver programs to determine long-term objectives & system impact.
• Work with governing agencies to improve waiver services & direct policy development, & implementation for DODD & other entities.
• Provides public relations, constituent training, & policy guidance to county boards, & other internal & external stakeholders.
• Formulates, evaluates, & analyzes policies & practices related to the services coordination responsibilities of the county boards.
• Assists in the development, testing, & training of systems used by county boards to assess individual needs & prepare service plans that meet state requirements.
• Collects data from county board service coordinators, prepares reports & offers solutions to problems to county stakeholders.
• Assists Medicaid Development & Administration (MDA) staff & stakeholders with systems improvements that relate well to county board service coordination & waiver services.
• Plans, coordinates & implements training & technical assistance that supports a local DD service delivery system.
• Directs & administers initiatives to support system innovations & technical assistance related to services to individuals with developmental disabilities to assure health, safety, service satisfaction & the quality of the provision of locally planned & statewide Medicaid services & supports (e.g., programs, grants & interagency agreements that support local administration, self-determination & Medicaid principles & provide information to constituents, general public, individuals with DD & families, health care providers, county boards of DD (CBDD), various related associations, government agencies regarding programs, policies, procedures, philosophies, strategies, etc. that ensure health & safety & enhance quality of life for individuals with DD & families).
• Develops, implements & evaluates policy, goals & objectives for the department regarding programs & initiatives, designing systems & procedures to assess outcomes.
• Participates in development of budget initiatives for department biennial budget, grants & interagency agreements & recommends, monitors & approves expenditures according to approved guidelines / procedures.
• Conducts reviews of Individual Service Plans, projected cost, provider rate determinations & related.
• Monitors data related to costs & services as entered by CBDD & waiver providers to ensure complete & accurate systems information.
• Conducts follow-up technical assistance & research required for responding appropriately to issues & problems identified within a system & makes recommendations for resolution of such issues.
• Produces informational & management reports regarding specialty areas for review, approval & dissemination.
• Oversees distribution of approved reports as required.
• Participates in systems development & provides feedback on system design & makes recommendations for system changes.
• Participates in system testing & provides feedback & assists in system implementation.
• Represents department, MDA or unit at various local, state or national meetings, training conference, seminars or workgroups to exchange & communicate state-of-the-art information to resolve concerns & problems which impact on quality-of-life individuals with DD.
• Coordinates implementation of stakeholder committees for issues related to service coordination.
• Works collaboratively with relevant state & local agencies & other department staff in all aspects of job duties.
• Performs other duties as assigned.

Preferred Qualifications :

1) Registered nurse within the State of Ohio.

2) Experience writing and developing healthcare policy.

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

Qualifications

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance AND 36 months' experience in planning & administering 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).

12 months experience as a Medicaid Health Systems Administrator 2, 65296.

Equivalent of Minimum Class Qualifications for Employment noted above.

Note : education & experience is to be commensurate with approved position description on file.

Job Skills : Health Administration, Nursing, Customer Service, Executive Leadership, Management, Regulatory Compliance, Leading Others, Collaboration, Critical Thinking, Decision Making, Problem Solving