This position is 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
• Increase program transparency and accountability
What You Will Do at ODM:
Office : Operations
Bureau : Business Operational Support
Working Title : Medicaid Health Systems Specialist (PN:20047592)
JOB PREVIEW :
The Registered Nurse (RN) in this position will:
- Utilize the Ohio Administrative Code (OAC), and Federal rules, policies, and procedures to make clinical/medical based definitive decisions to determine disability
- Review and evaluate medical records and statistical reports
- Frequently use electronic medical documentation and software applications, interact with providers, other agencies and external stakeholders
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.
Qualifications
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.
-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