What are the responsibilities and job description for the Medicaid Health Systems Specialist position at State of Ohio Jobs?
The Division of Medicaid Development and Administration works with state agency personnel and stakeholders to develop policies related to Medicaid-funded services for people with developmental disabilities. Responsibilities include drafting waiver applications, statutes, rules, and guidance for home and community-based services waivers.
What you will do as a Medicaid Health Systems Specialist:
- Design, plan and evaluate a regional system of training & technical assistance that supports the local county boards of Developmental Disabilities (DD) service delivery.
- Implement initiatives to support system innovations and policy technical assistance related to services available to individuals with developmental disabilities through the provision of locally planned & statewide Medicaid services & supports.
- Assist in the development & implementation of Medicaid policy, goals & objectives for the department regarding programs & initiatives, designs systems & procedures to assess outcomes.
- Supply required data & program narrative for department biennial budget requests as requested.
- Collaborate with stakeholders to provide interpretation & implementation of Medicaid & other applicable regulations, rules & policies as a part of an overall technical assistance & training resource.
- Provides training sessions, webinars, & a variety of activities to share information with the field (CBDD, individuals, families, providers, advocates, etc.) to ensure consistency & uniformity of policy application across the state.
- Work as a team in development of training in all components of the Medicaid Service System (MSS) for stakeholders, provide system assistance to the field daily.
- Additional systems required will be the Medicaid Information Technology System (MITS), and the Imagine365 CRM system. Other technology systems may be required to be utilized.
- Coordinate & compose responses to correspondence & inquiries from the field.
- Review work for professional presentation, accuracy of information, clarity, etc. & operates personal computer to edit & recommend change to documents, letters, targeted for general distribution.
- Develop materials & presentation required for statewide, regional & single site training & technical assistance.
- Develops material for publication, presentation & use in technical assistance.
- Acts as liaison with existing organizations in a regional area (i.e., Ohio Association of Adult Services, Ohio Superintendent’s Association).
- Participates in rule & statute review, revision & promulgation.
- Respond to inquiries and participates in process of acting on requests from providers & CB/DD to waive requirements of Ohio Administrative Code.
- Represent department, MDA, or unit at or attends various local, state, or national meetings, training conferences & seminars to exchange & communicate state-of-the-art information to resolve concerns & problems which impact on the quality of life of individuals with DD.
- Participate in workgroups as assigned.
- Coordinate implementation of stakeholder committees for issues related to case management service coordination.
- Work collaboratively with relevant state & local agencies & other department staff in all aspects of job duties.
- Monitor data related to costs & services as entered by CB/DD & waiver providers to ensure complete & accurate systems information.
- Monitor and directs responses to daily inquiries from electronic mail and telephone for technical assistance.
- Provide the follow-up technical assistance & research required for responding appropriately to issues & problems identified within a system.
- Produce informational & management reports regarding specialty areas for review, approval & dissemination.
- Participate in systems development & provides feedback on system design & makes recommendations for system changes.
- Participate in system testing & provides feedback & assistance in system implementation.
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.
Position requiring assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery requires current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03 & 4723.09 of Ohio revised code; additional 24 mos. exp. in nursing.
Job Skills: Health Administration
Supplemental Information- Or for positions other than those requiring valid license as registered nurse, completion of undergraduate core program in business administration, social or behavioral science, health or statistics; additional 24 mos. exp. specific to subject area of which 12 mos. exp. in use of spreadsheet and database software. Note: education & experience to be commensurate with approved position description on file.
- Or for positions other than those requiring valid license as registered nurse, 24 months experience as Medicaid Health Systems Analyst, (65291) may be substituted for the experience required, but not for the mandated licensure.
- 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
- No additional materials will be accepted after the closing date; in addition, you must clearly demonstrate how you meet minimum qualifications.
- The final candidate selected for the position will be required to undergo a criminal background check. Rule 5123-2-02, “Background Investigations for Employment,” outlines disqualifying offenses that will preclude an applicant from being employed by the Department of Developmental Disabilities.
- The final applicant selected for this position will be required to submit to urinalysis prior to the appointment to test for illegal drug use.
- Hourly wage will be paid at step 1, unless otherwise specified by collective bargaining agreement or rules outlined in the ORC/OAC.
- Requires travel throughout State of Ohio & may require overnight stay.
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 WorkplaceThe 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.
