What are the responsibilities and job description for the HYBRID - Hospital Policy SDP Program Manager (Medicaid Health Systems Administrator 1) position at Ohio Department of Medicaid?
What You Will Do At ODM
Office: Policy
Bureau: Health Plan Policy
Classification: Medicaid Health Systems Administrator 1 (PN 20101605)
Job Overview
The Ohio Department of Medicaid (ODM) is seeking a skilled professional to join ODM’s Hospital Policy Team. The Hospital Policy Team is responsible for the development and implementation of Ohio Administrative Code (OAC) rules, establishing coverage and reimbursement policies, and managing special programs related to hospital services as part of the Ohio Medicaid Program. This position will handle the day-to-day activities of the various State Directed Payment (SDP) programs authorized under 42 CFR 438.6(c) and enacted through the legislative process. As an Hospital Policy SDP Program Manager, your responsibilities will include:
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).
Technical Skills: Public Health, Program Management
Professional Skills: Collaboration, Organizing and Planning, Analyzation, Interpreting Data
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Feb 2, 2025, 11:59:00 PM
Work Location
Lazarus 5
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$37.53/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Classified
Union
Exempt from Union
Primary Job Skill
Health Administration
Technical Skills
Program Management, Public Health
Professional Skills
Analyzation, Collaboration, Interpreting Data, Organizing and Planning
Agency Overview
THIS POSITION MAY BE TELEWORK ELIGIBLE ON A HYBRID BASIS
About Us
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.
Responsibilities
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:
Office: Policy
Bureau: Health Plan Policy
Classification: Medicaid Health Systems Administrator 1 (PN 20101605)
Job Overview
The Ohio Department of Medicaid (ODM) is seeking a skilled professional to join ODM’s Hospital Policy Team. The Hospital Policy Team is responsible for the development and implementation of Ohio Administrative Code (OAC) rules, establishing coverage and reimbursement policies, and managing special programs related to hospital services as part of the Ohio Medicaid Program. This position will handle the day-to-day activities of the various State Directed Payment (SDP) programs authorized under 42 CFR 438.6(c) and enacted through the legislative process. As an Hospital Policy SDP Program Manager, your responsibilities will include:
- analyzing and evaluating policies related to new and existing SDP programs
- developing and maintaining models related to new and existing SDP programs
- overseeing various SDP activities, including coordinating the process of gathering Memorandum of Understandings (MOUs) for each SDP
- developing hospital payment & coverage policies related to hospitals
- drafting new OAC rules, completing revisions to existing OAC rules, managing the rule filing process, and implementing necessary changes across the agency to support the rules
- amending State Plan pages as necessary
- ensuring policies comply with federal & state regulations, rules, and laws
- collaborating with other areas of ODM, sister state agencies, external stakeholder groups and responding to inquiries from internal and external stakeholders
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.
Technical Skills: Public Health, Program Management
Professional Skills: Collaboration, Organizing and Planning, Analyzation, Interpreting Data
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Feb 2, 2025, 11:59:00 PM
Work Location
Lazarus 5
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$37.53/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Classified
Union
Exempt from Union
Primary Job Skill
Health Administration
Technical Skills
Program Management, Public Health
Professional Skills
Analyzation, Collaboration, Interpreting Data, Organizing and Planning
Agency Overview
THIS POSITION MAY BE TELEWORK ELIGIBLE ON A HYBRID BASIS
About Us
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.
Responsibilities
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.
Salary : $38
