Medicaid Health Systems Administrator 2 (200004E5)
Serves as agency manager of the Medicaid Home & Community Based Services (HCBS) waiver & Supported Living (SL) services Program in the Office of Provider Certification: Develops Provider Certification program rules, policies & procedures & remains current on rules/laws affecting service delivery within the office; conducts high-level analysis of proposed & existing legislation, prepares proposals & recommendations & directs work teams to administer the certification process. Supervises staff (e.g. plans, schedules & monitors work; recommends commendation & discipline; evaluates employee performance, trains in new programs, policies & procedures, authorizes leave requests, assigns & reviews work, monitors schedules, assists with complex issues). Monitors unit review volume and develops and implements strategies to appropriately manage certification reviews within administrative code timelines. Responsible for implementation of enhancements & maintenance of the Provider Services Management (PSM) application & the provider search database (e.g., responsible to address any provider with concerns that impacts a county board & their ability to authorize the provider to deliver services & reimbursement for services). Ensures the provider search database is up-to-date, which allows free public access to those requiring provider services. Develops customer service friendly recommendations for provider certification unit. Coordinates denial, revocation, suspension & voluntary relinquishment of certification with legal & other offices within the department, prepares correspondence & maintains record of such actions, & participates in appeal process/hearings as requested. Provides technical assistance to applicants, other offices & divisions of the department & stakeholder groups. Coordinates sharing of applicant information with the Claims Services Unit, other Medicaid operational units, the Fiscal Division, & the Ohio Department of Medicaid (ODM). Participates in interagency meetings & committees related to certification. Provides input for budget, policy, procedures, goals & objectives & administrative rules.
Implements new polices & procedures (e.g., Time-limited certification, Application Fees) to achieve & maintain compliance with the Ohio Administrative Code. Utilize Medicaid Information Technology System (MITS) & Ohio Medicaid Enterprise System (OMES) to carry out & monitor services for users (e.g., constantly improve operations & aide in streamlining functionality for managed care plans, fee-for-service providers, & Medicaid consumers) Prepares reports & data related to performance measures & other outcomes related to provider certification County Board registration & certification. Coordinates & implements the registration & certification process for County Board employees. Oversees the department approval process for training, seminars, & continuing professional development units. Provides training to internal & external staff regarding rules & laws affecting certification & recertification. Performs other duties within range & scope of position.
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 24 mos. exp. 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 analysis).
Or 24 months experience as a Medicaid Health Systems Administrator 1, 65295.
Note: education & experience is to be commensurate with approved position description on file.
-Or equivalent of Minimum Class Qualifications for Employment noted above.
Knowledge of social or behavioral science; business or public administration and management practices; health care federal & state laws & regulations; public medical assistance programs; agency policies & procedures; health care statistics, terminology & methods; purchasing & payment practices of health care services; comprehensive health planning; public budgeting & finance; public relations; employee training & development; supervisory principles & techniques. Skill in operating personal computer & applicable software applications. Ability to analyze & apply multiple factors & present findings & conclusions; read & comprehend clinical records; determine appropriate level of health care; determine accuracy of clinical assessments & data; assess & monitor quality assurance & corrective action plans; prepare & oversee comprehensive & technical reports; interpret social welfare information & technical materials in books, journals & manuals; handle sensitive contacts & inquires from public, consumers, providers & government officials in person, via telephone &/or written correspondence.
Demonstrated competence in the following: developing self, adapting for impact, continuously improving quality, focusing on customers, acting with integrity, building productive relationships, developing staff & others, fostering team development, directing & measuring work, informing, managing priorities, making effective decisions, valuing cultural diversity, managing projects, leveraging organizational resources, demonstrating intellectual capacity, &/or thinking strategically, managing change, navigating organizational politics, cultivating vision & purpose, innovating, solving problems, & acting decisively.
(*) Developed after employment.
Hourly wage will be paid at step 1, unless otherwise specified by collective bargaining agreement or rules outlined in the ORC/OAC.
UNUSUAL WORKING CONDITIONS:
Requires travel throughout State of Ohio & may require overnight stay. Must be willing & able to secure a Driver License OR supply your own transportation.
No additional materials will be accepted after the closing date; in addition, you must clearly demonstrate how you meet minimum qualifications.
DODD is an affirmative action and equal opportunity employer. To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform job functions, unless such accommodation would cause an undue hardship.
Background Check Information
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. AN APPLICANT WITH A POSITIVE TEST RESULT WILL NOT BE OFFERED EMPLOYMENT.