What are the responsibilities and job description for the HYBRID - (Provider Compliance) Medicaid Health Systems Specialist position at Ohio Department of Medicaid?
What You Will Do At ODM
Office: Operations
Bureau: Network Management
Classification: Medicaid Health Systems Specialist (PN 20046550)
Job Overview
The Ohio Department of Medicaid is seeking an experienced healthcare professional to be a part of the Network Management Compliance Team. As a provider compliance team member your responsibilities will include:
Completion of undergraduate core program in business administration, social or behavioral science, health or statistics; additional 24 months experience specific to subject area of which 12 months experience in use of spreadsheet and database software.
Job Skills: Health Administration
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Feb 14, 2025, 10:59:00 PM
Work Location
Lazarus 4
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$33.45/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Classified
Union
1199
Primary Job Skill
Health Administration
Technical Skills
Health Administration
Professional Skills
Responsiveness, Time Management, Verbal Communication, Written Communication
Agency Overview
THIS POSITION WILL 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.
Office: Operations
Bureau: Network Management
Classification: Medicaid Health Systems Specialist (PN 20046550)
Job Overview
The Ohio Department of Medicaid is seeking an experienced healthcare professional to be a part of the Network Management Compliance Team. As a provider compliance team member your responsibilities will include:
- Enrolling Waiver providers.
- Conducting Background checks for providers and PECOS verifications.
- Reviewing disclosed convictions, disqualifying offenses, and board actions for provider applications.
- Create notices for providers (denials, suspensions, terminations).
- Providing technical assistance to providers as well as other internal and external customers.
- Applying Federal and State policy to ensure Medicaid provider compliance.
Completion of undergraduate core program in business administration, social or behavioral science, health or statistics; additional 24 months experience specific to subject area of which 12 months experience in use of spreadsheet and database software.
- Or 24 months experience as Medicaid Health Systems Analyst, (65291).
- Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required.
Job Skills: Health Administration
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Feb 14, 2025, 10:59:00 PM
Work Location
Lazarus 4
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$33.45/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Classified
Union
1199
Primary Job Skill
Health Administration
Technical Skills
Health Administration
Professional Skills
Responsiveness, Time Management, Verbal Communication, Written Communication
Agency Overview
THIS POSITION WILL 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 : $33
