Care systems and administrator health systems administrator

What You Will Do At ODM:

Office: Managed Care

Bureau: Member Services

Classification: Medicaid Health Systems Administrator 2 (PN: 20102513)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking a professional to join the Bureau of Member Services. As Managed Care Systems and Payments Administrator , your responsibilities will include:

• Supervising staff, delegating responsibilities, and monitoring performance through SMART goals and coaching
• Leads policy development and system oversight for Medicaid Managed Care, and MyCare Ohio Programs.
• Develops and implements OAC rules and provider agreement requirements related to enrollment and capitation payments.
• Oversees system testing, defect resolution, and capitation payment adjustments in coordination with internal teams and CMS.
• Serves as the primary liaison for managed care plan inquiries and communicates updates to ODM leadership.
• Manages design and review of enrollment, eligibility, and capitation reports, including 834/820 files and dashboards.
• Coordinates audit responses for capitation and enrollment inquiries from state and federal oversight bodies.
• Leads managed care components of Ohio Benefits and Fiscal Intermediary testing, training, and transition activities.
• Represents the section in internal and external stakeholder meetings in the absence of the Bureau Chief.
  
  

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.
  
  

Technical Skills:

Health Administration

Professional Skills: Attention to Detail, Collaboration,

Critical Thinking, Decision Making, Goal Setting, Managing Meetings, Organizing and Planning, Verbal Communication, Written Communication

Organization

Medicaid

Agency Contact Name and Information

[email protected]

Unposting Date

Sep 21, 2025, 11:59:00 PM

Work Location

Lazarus 4

Primary Location

United States of America-OHIO-Franklin County-Columbus

Compensation

$43.09/hour

Schedule

Full-time

Work Hours

8:00 am - 5:00 pm

Classified Indicator

Classified

Union

Exempt from Union

Primary Job Skill

Health Administration

Technical Skills

Health Administration

Professional Skills

Attention to Detail, Collaboration, Critical Thinking, Decision Making, Goal Setting, Managing Meetings, Organizing and Planning, Verbal Communication, Written Communication

Agency Overview

About Us:

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help.

Ohio Department Of Medicaid Plays a Unique And Necessary Role In Supporting The Governor’s Vision. As The Single State Medicaid Agency Responsible For Administering High-quality, Person-centric Healthcare, The Department Is Committed To Supporting The Health And Wellbeing Of Nearly One In Every Four Ohioans Served. We Do So By:

• Delivering a personalized care experience to more than three million people served.
• Improving care for children and adults with complex behavioral health needs.
• Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.
• Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.
• Ensuring financial transparency and operational accountability across all Medicaid programs and services.