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Medicaid Health Systems Specialist (PN 20083695)
Medicaid Health Systems Specialist (PN 20083695)Ohio Jobs • Columbus, OH, US
Medicaid Health Systems Specialist (PN 20083695)

Medicaid Health Systems Specialist (PN 20083695)

Ohio Jobs • Columbus, OH, US
2 days ago
Job type
  • Full-time
  • Part-time
Job description

Medicaid Health Systems Specialist

The Medicaid Health Systems Specialist serves as a key team member responsible for reviewing, coordinating, and responding to inquiries regarding services and supports through a formalized statewide communication system. This position plays a central role in supporting system innovation, policy interpretation, and technical assistance related to Medicaid services for individuals with developmental disabilities.

Communication & Coordination

  • Review, coordinate, and respond to inquiries related to services and supports via a statewide communication system
  • Compose and manage responses to correspondence and field inquiries.
  • Provide information to constituents, individuals with developmental disabilities (DD), families, healthcare providers, county boards of DD (CB / DD), associations, and government agencies.
  • Ensure health, safety, service quality, and satisfaction through clear and accurate communication.

Policy, Program & System Support

  • Assist in developing and implementing Medicaid policy, goals, and objectives for departmental programs and initiatives.
  • Design systems and procedures to assess program outcomes.
  • Provide data and narrative components for biennial budget requests.
  • Support system innovations and technical assistance related to statewide Medicaid services, grants, interagency agreements, and self-determination efforts.
  • Participate in rule and statute review, revision, and promulgation.
  • Respond to and assist with requests for waivers of Ohio Administrative Code requirements.
  • Training & Technical Assistance

  • Provide interpretation, guidance, and implementation support for Medicaid rules, regulations, and policies.
  • Deliver training sessions, webinars, and statewide or regional activities to ensure consistent policy application.
  • Collaborate with team members to develop training content for all components of the Medicaid Service System (MSS).
  • Offer daily system assistance to the field, including CB / DDs, providers, individuals, families, and advocates.
  • Systems & Technology

  • Utilize and support field use of key systems including :
  • Medicaid Information Technology System (MITS)
  • Imagine365 CRM
  • Other required technology platforms
  • Review documents for accuracy, clarity, and professional presentation.
  • Develop materials and presentations for training, technical assistance, and publication.
  • Participate in system development, testing, feedback, implementation, and recommendations for improvement.
  • Stakeholder Engagement & Representation

  • Act as liaison to regional organizations (e.g., Ohio Association of Adult Services, Ohio Superintendent's Association).
  • Represent the department at local, state, and national meetings, conferences, and seminars.
  • Coordinate and support stakeholder committees related to case management and service coordination.
  • Work collaboratively with internal staff and state / local agencies.
  • Monitoring, Reporting & Data Oversight

  • Monitor cost and service data entered by CB / DDs and waiver providers to ensure accuracy.
  • Track and respond to daily inquiries via email and phone.
  • Provide follow-up assistance and conduct research to resolve system issues.
  • Produce informational and management reports related to specialty areas for review and dissemination.
  • Other Duties

  • Perform additional responsibilities as assigned to support department operations and initiatives.
  • Why Work for the State of Ohio

    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.
  • 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

    Technical Skills : Health Administration, Policy Direction, Professional, Regulatory Compliance

    Professional Skills : Collaboration, Attention to Detail, Customer Focus, Time Management

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

    Supplemental Information

  • 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.
  • 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.
  • ADA Statement

    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 Workplace

    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.

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    Medicaid Specialist • Columbus, OH, US

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