State of Ohio
Eligibility Compliance Specialist (Medicaid Health Systems Specialist)
State of Ohio, Columbus, Ohio, United States, 43224
Job Description - Eligibility Compliance Specialist (Medicaid Health Systems Specialist)
(2600004B)
Organization Medicaid
Unposting Date Jan 22, 2026, 4:59:00 AM
Work Location Lazarus 4 50 West Town Street Columbus 43215
Primary Location United States of America-OHIO-Franklin County-Columbus
Compensation : $34.96/hour
Schedule Full-time
Union : 1199
Primary Job Skill Health Administration
Technical Skills : Health Administration
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 collaboratively with 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.
Job Description What You Will Do at ODM:
Office:
Operations
Bureau:
Business Operational Support
Classification:
Medicaid Health Systems Specialist (PN20037632)
Job Overview:
The Ohio Department of Medicaid is seeking an experienced professional to work in our Eligibility Compliance Unit. As a Medicaid Health Systems Specialist, your responsibilities will include:
Monitor eligibility determinations and processes of County Departments of Job and Family Services (CDJFS) to ensure compliance with Medicaid rules.
Work with CDJFS to correct eligibility issues identified by business intelligence reporting and other Ohio Department of Medicaid work units.
Monitor reports to assist in the administration of Medicaid eligibility (application timeliness, renewal timeliness, and change processing) and assist in the creation of new monitoring reports.
Respond to inquiries from consumers, agency staff, stakeholders, and staff from other agencies.
Work closely with CDJFS to complete corrective action plans.
The preferred candidate will have experience determining Medicaid eligibility, monitoring compliance with Medicaid eligibility rules, troubleshooting Medicaid eligibility issues, and be proficient in Microsoft Excel.
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 ( e.g., 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 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.
Job Skills:
Health Administration
Supplemental Information Supplemental Info:
Compensation is as listed on the posting unless required by legislation or union contract.
The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full‑time, if selected.
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.
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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Organization Medicaid
Unposting Date Jan 22, 2026, 4:59:00 AM
Work Location Lazarus 4 50 West Town Street Columbus 43215
Primary Location United States of America-OHIO-Franklin County-Columbus
Compensation : $34.96/hour
Schedule Full-time
Union : 1199
Primary Job Skill Health Administration
Technical Skills : Health Administration
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 collaboratively with 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.
Job Description What You Will Do at ODM:
Office:
Operations
Bureau:
Business Operational Support
Classification:
Medicaid Health Systems Specialist (PN20037632)
Job Overview:
The Ohio Department of Medicaid is seeking an experienced professional to work in our Eligibility Compliance Unit. As a Medicaid Health Systems Specialist, your responsibilities will include:
Monitor eligibility determinations and processes of County Departments of Job and Family Services (CDJFS) to ensure compliance with Medicaid rules.
Work with CDJFS to correct eligibility issues identified by business intelligence reporting and other Ohio Department of Medicaid work units.
Monitor reports to assist in the administration of Medicaid eligibility (application timeliness, renewal timeliness, and change processing) and assist in the creation of new monitoring reports.
Respond to inquiries from consumers, agency staff, stakeholders, and staff from other agencies.
Work closely with CDJFS to complete corrective action plans.
The preferred candidate will have experience determining Medicaid eligibility, monitoring compliance with Medicaid eligibility rules, troubleshooting Medicaid eligibility issues, and be proficient in Microsoft Excel.
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 ( e.g., 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 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.
Job Skills:
Health Administration
Supplemental Information Supplemental Info:
Compensation is as listed on the posting unless required by legislation or union contract.
The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full‑time, if selected.
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.
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.
#J-18808-Ljbffr