HYBRID - Medicaid Eligibility Processing Spec. (Med Health Systems Spec)
Job description
HYBRID - Medicaid Eligibility Processing Spec. (Med Health Systems Spec)
(230004M7)THIS POSITION WILL BE TELEWORK ELIGIBLE ON A HYBRID BASIS.
About Us:
The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. ODM is implementing the next generation of Ohio Medicaid to fulfill its bold, new vision for Ohio’s Medicaid program - focusing on the individual rather than the business of managed care.
The goals of the next generation of Ohio Medicaid are:
- Emphasize a personalized care experience
- Improve care for children and adults with complex behavioral health needs
- Improve wellness and health outcomes
- Support providers in better patient care and
- Increase program transparency and accountability
What You Will Do at ODM:
Office: Operations
Bureau: Business Operational Support
Classification: Medicaid Health Systems Specialist, PN 20097686
As a Central Processing Team staff member, your responsibilities will include:
- Research and respond to legislative & consumer inquiries via written and telephone communication
- Communicate with internal and external stakeholders via email & letter correspondence
- Provide technical support for County JFS Medicaid eligibility determinations
- Provide technical support to contracted central processing project team
- Monitor and respond to policy inquiries related to presumptive eligibility
- Conduct user acceptance testing for upcoming eligibility system releases and updates
The ideal candidate for this position must be able to demonstrate exceptional written and verbal business communication skills
What’s in it for you:
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
- Quality, affordable, and competitive medical benefits are offered through the available Ohio Med plans.
Dental, Vision and Basic Life Insurance
- Dental, vision, and basic life insurance premiums are free after completed eligibility period. Length of eligibility period is dependent on union representation.
Time Away From Work and Work/Life Balance
- Paid time off, including vacation, personal, and sick leave
- 11 paid holidays per year
- Childbirth/Adoption leave
Employee Development Funds
- The State of Ohio offers a variety of educational and professional development funding that varies based on whether you are a union-exempt employee or a union-represented employee.
Ohio Public Employees Retirement System
- OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee’s salary. Visit the OPERS website for more information.
Deferred Compensation
- The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.
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.
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.
Note: education & experience to be commensurate with approved position description on file.
Major Worker Characteristics
Knowledge of social or behavioral science or pre-medicine or comparable field; business administration; federal & state laws & regulations; agency policies & procedures; health care statistics, terminology & methods; public relations; public medical assistance programs; purchasing & payment practices of health care services; payment/pricing strategies; nursing. Skill in operating personal computer & applicable software applications (e.g., word processing; spreadsheet; databases). Ability to analyze multiple factors, apply factors & present findings & conclusions; read & comprehend clinical records; determine level of care; determine accuracy assessments & data; assess & monitor quality assurance & corrective action plans; prepare comprehensive & technical reports; interpret social welfare information & technical materials in books, journals & manuals; perform complex algebraic formulas; read & comprehend clinical records & residence &/or clinical data &/or quality assurance/corrective action plans to make appropriate assessments/referrals &/or to determine level of care & need; prepare review &/or evaluate records, reports, clinical assessments/data &/or financial/grant documents; handle routine & sensitive contacts with & inquiries from public, consumers, providers, & government officials in person, via telephone &/or through written correspondence.
Supplemental Information:
- Compensation is as listed on the posting unless required by legislation or union contract.
- Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.
- Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.
- 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 final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration.
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