Medicaid Health Systems Administrator 2 (pn 20102249)
- Lead cross-functional projects to evaluate, enhance, and implement Medicaid services and programs, ensuring they meet quality, cost, and efficiency goals.
- Oversee the planning, execution, and monitoring of projects from initiation to completion.
- Manage resources effectively, including staff, budgets, and timelines, to achieve project goals.
- Provide leadership and direction to project teams and ensure project milestones are met.
- Analyze Medicaid service data, including expenditures, service authorizations, and program performance.
- Ensure the accuracy and consistency of data entered into Medicaid systems, identifying and correcting discrepancies when necessary.
- Prepare and present regular reports on program performance, cost savings, and other key metrics.
- Use data to drive decision-making, program improvements, and policy changes.
- Develop, revise, and implement Medicaid policies and procedures to ensure compliance with state and federal regulations.
- Evaluate the effectiveness of policies and recommend changes to improve service delivery, cost-effectiveness, and patient outcomes.
- Work with internal and external stakeholders to ensure alignment and understanding of new and revised policies.
- Monitor the implementation of policies and conduct periodic reviews to assess their impact.
- Direct and administer initiatives to support system innovations and technical assistance.
- Use clinical background to conduct reviews of Individual Service Plans and related service authorizations to make recommendations on service improvement and service authorization
- Evaluate and direct activities that support DODD HCBS waiver utilization management.
- Analyze service delivery costs and implement strategies to improve cost-efficiency without compromising the quality of care.
- Review and manage high-cost services, ensuring they are cost-effective and meet the needs of individuals.
- Work with service providers and other stakeholders to identify cost-saving opportunities and enhance service delivery.
- Conduct cost-benefit analyses for Medicaid waivers, services, and programs.
- 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.
- Facilitate discussions and negotiations with stakeholders to resolve issues, align goals, and achieve consensus on policy initiatives.
- Provide clear and effective communication to all stakeholders regarding policy updates, program changes, and best practices.
- Ensure Medicaid programs and services comply with all relevant state and federal regulations, guidelines, and policies.
- Conduct regular audits to assess program compliance and identify potential risks or areas for improvement.
- Stay updated on changes in Medicaid regulations and adjust practices accordingly to ensure ongoing compliance.
- Develop and deliver training materials for staff on Medicaid policies, service delivery standards, and system processes.
- Provide ongoing support to staff to ensure they are equipped to deliver high-quality services.
- Create and deliver presentations on complex Medicaid topics to various audiences, ensuring material is easily understood.
- Identify opportunities for process improvements in Medicaid service delivery, ensuring that all operations are running efficiently and cost-effectively.
- Work with teams to resolve any issues related to program underperformance or service quality concerns.
- Lead initiatives to improve the overall quality of Medicaid services and ensure continuous improvement in service delivery.
- To request a reasonable accommodation due to disability, please contact the ADA Coordinator by email at [email protected].
- 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.
Recommended Jobs
Supplier Relationship Manager - Cincinnati, OH
POSITION SUMMARY Leads execution of Supplier Rescue Projects, developing the project scope and phases, setting up the project team and reporting progress and results to top management. This posit…
Shipping/Receiving Clerk I
Job Responsibilities: The key purpose of this function is package product as per prescribed methods and or to eliminate damage to product while in transit. Process documentation utilizing internal…
Senior Manager, Logistics
Job Summary: The Senior Manager, Logistics oversees all aspects of warehouse and logistics operations, including inbound receiving, outbound shipping, inventory management, and production line sup…
Family Medicine Residency Faculty MD/DO - Eaton and Greenville, Ohio
Family Medicine Residency Faculty – ACGME-Accredited Program An ACGME-accredited Family Medicine Residency Program is recruiting a Board Certified Family Medicine physician to join its faculty…
Service Champion
As a Service Champion, you will be responsible for: Serving each guest courteously, quickly and efficiently with a sincere, positive, pleasant and enthusiastic attitude Filling orders Operat…
Manager Solutions Design - REMOTE
Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of …
Asset Wealth Management Operations - Discretionary Accounts Control - Vice President Project Manager - Columbus. OH
Job Description Join a dynamic team where your organizational skills and problem-solving abilities will make a real difference. As a key contributor, you’ll collaborate with stakeholders across mu…
Project Manager (IT)
Job Summary JOB DESCRIPTION Vertiv is hiring a Project Manager in Westerville, Ohio. This role involves traditional project management responsibilities for large scale projects with global, e…
Infrastructure Manager
About Re:Build Manufacturing Re:Build Manufacturing is a growing family of industrial and engineering businesses combining enabling technologies, operational superiority, and strategic M&A to …
Physician Assistant
We are seeking a Physician Assistant to join our team! You will provide healthcare services, under the supervision of a physician. ~3 weeks paid vacation ~ Assigned medical assistant daily to ro…