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Ohio

Member Services Operations and Enrollment Manager (Medicaid Health Systems Admin

Ohio, Columbus, Ohio, United States, 43224

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What You Will Do At ODM: Office: Managed Care

Bureau: Member Services

Classification: Medicaid Health Systems Administrator 1 (PN: 20101842)

Job Overview:

Overseeing statewide initiatives related to Medicaid health systems access, with a focus on managed care enrollment and member services

Managing key components of Ohio’s Medicaid programs, including services for Aged, Blind & Disabled (ABD), MAGI, and MyCare Ohio populations

Directing membership services operations, coordinating audits and special projects, and ensuring alignment across multiple stakeholders including County Departments of Job & Family Services (CDJFS), Managed Care Organizations (MCOs), the Managed Care Enrollment Center (MCEC), and other state agencies

Leading efforts related to open enrollment, review of MCO member materials, tracking of Value Added Benefits, and ensuring quality of Medicaid Consumer Hotline phone calls

High-level data analysis, community outreach, and technical consultation to support access to care and improve member experience

The ideal candidate will be a collaborative leader with strong analytical, communication, and project management skills, capable of navigating complex systems and driving impactful change across Ohio’s Medicaid landscape.

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 months experience in the delivery of a 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 database analysis).

Or 12 months experience as a Medicaid Health Systems Specialist, 65293.

Or equivalent of Minimum Class Qualifications for Employment noted above.

Technical Skills: Health Administration

Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication

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