Medicaid Health Systems Administrator 2 (pn 20102249)

Join Our Team!

Accepting applications for a Medicaid Health Systems Administrator 2

The Department of Developmental Disabilities (DODD) is a trauma informed care agency focused on implementing our core values and providing support to people with developmental disabilities. We oversee a statewide system of supportive services that focus on ensuring the health and safety, supporting access to community participation, and increasing opportunities for meaningful employment. To learn more about DODD click here. 

The Medicaid Health System Administrator 2 plays a key role in overseeing the management, administration, and enhancement of Medicaid services. This position requires an experienced professional with a strong background in Medicaid program management, policy development, cost analysis, stakeholder engagement, and regulatory compliance. The administrator will be responsible for leading projects aimed at improving Medicaid services, ensuring cost-effective service delivery, analyzing data, and collaborating with internal and external stakeholders to ensure alignment with organizational goals.

If you have a passion for improving healthcare access, managing complex systems, and ensuring that Medicaid programs meet the needs of individuals with developmental disabilities, this is an excellent opportunity to join our team.

What will you do?

Project Leadership & Management:

o   Lead cross-functional projects to evaluate, enhance, and implement Medicaid services and programs, ensuring they meet quality, cost, and efficiency goals.

o   Oversee the planning, execution, and monitoring of projects from initiation to completion.

o   Manage resources effectively, including staff, budgets, and timelines, to achieve project goals.

o   Provide leadership and direction to project teams and ensure project milestones are met.

Data Analysis & Reporting:

o   Analyze Medicaid service data, including expenditures, service authorizations, and program performance.

o   Ensure the accuracy and consistency of data entered into Medicaid systems, identifying and correcting discrepancies when necessary.

o   Prepare and present regular reports on program performance, cost savings, and other key metrics.

o   Use data to drive decision-making, program improvements, and policy changes.

Policy Development & Implementation:

o   Develop, revise, and implement Medicaid policies and procedures to ensure compliance with state and federal regulations.

o   Evaluate the effectiveness of policies and recommend changes to improve service delivery, cost-effectiveness, and patient outcomes.

o   Work with internal and external stakeholders to ensure alignment and understanding of new and revised policies.

o   Monitor the implementation of policies and conduct periodic reviews to assess their impact.

o   Direct and administer initiatives to support system innovations and technical assistance.

o   Use clinical background to conduct reviews of Individual Service Plans and related service authorizations to make recommendations on service improvement and service authorization

Cost Management & Efficiency:

o   Evaluate and direct activities that support DODD HCBS waiver utilization management.

o   Analyze service delivery costs and implement strategies to improve cost-efficiency without compromising the quality of care.

o   Review and manage high-cost services, ensuring they are cost-effective and meet the needs of individuals.

o   Work with service providers and other stakeholders to identify cost-saving opportunities and enhance service delivery.

o   Conduct cost-benefit analyses for Medicaid waivers, services, and programs.

Stakeholder Engagement & Communication:

o   Work collaboratively with multiple internal teams, county boards, external agencies, and service providers to ensure Medicaid programs are effectively managed and aligned with organizational objectives.

o   Facilitate discussions and negotiations with stakeholders to resolve issues, align goals, and achieve consensus on policy initiatives.

o   Provide clear and effective communication to all stakeholders regarding policy updates, program changes, and best practices.

Regulatory Compliance & Risk Management:

o   Ensure Medicaid programs and services comply with all relevant state and federal regulations, guidelines, and policies.

o   Conduct regular audits to assess program compliance and identify potential risks or areas for improvement.

o   Stay updated on changes in Medicaid regulations and adjust practices accordingly to ensure ongoing compliance.

Training & Staff Development:

o   Develop and deliver training materials for staff on Medicaid policies, service delivery standards, and system processes.

o   Provide ongoing support to staff to ensure they are equipped to deliver high-quality services.

o   Create and deliver presentations on complex Medicaid topics to various audiences, ensuring material is easily understood.

Problem Solving & Process Improvement:

o   Identify opportunities for process improvements in Medicaid service delivery, ensuring that all operations are running efficiently and cost-effectively.

o   Work with teams to resolve any issues related to program underperformance or service quality concerns.

o   Lead initiatives to improve the overall quality of Medicaid services and ensure continuous improvement in service delivery.

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  To request a reasonable accommodation due to disability, please contact the ADA Coordinator by email at EEO-DiversityAffairs@dodd.ohio.gov.

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.

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. 

Job Skills: Health Administration, Project Management, Research, Collaboration, Strategic Thinking, Results Oriented

• Hourly wage will be paid at step 1, unless otherwise specified by collective bargaining agreement or rules outlined in the ORC/OAC.
• 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. 
• No additional materials will be accepted after the closing date; in addition, you must clearly demonstrate how you meet minimum qualifications.
• Requires travel throughout State of Ohio & may require overnight stay. Must be willing & able to secure a Driver License OR supply your own transportation.

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.

The 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.