Medicaid Health Systems Specialist

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Children&Youth N. High Complex (DCYNHC)

246 North High Street

Columbus, 43215

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About us

Our mission is to promote positive, lifelong outcomes for Ohio youth through early intervention, quality education, and family support programs. At DCY, we offer our employees a rewarding work experience in public service helping Ohioans achieve a sustainable lifestyle that includes generous benefit options and a flexible work life balance making our agency a great place to work! To learn more about DCY, please visit our website at Department of Children and Youth | Ohio.gov.

Location Requirements

DCY's core hours of operation are Mon-Fri from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across DCY divisions. Employees may begin as early as 7:00am & as late as 9:00am, based on supervisory approval. This position performs work on-site daily at DCY's office space.

'',''!*!

About us

Our mission is to promote positive, lifelong outcomes for Ohio youth through early intervention, quality education, and family support programs. At DCY, we offer our employees a rewarding work experience in public service helping Ohioans achieve a sustainable lifestyle that includes generous benefit options and a flexible work life balance making our agency a great place to work! To learn more about DCY, please visit our website at Department of Children and Youth | Ohio.gov.

Location Requirements

DCY's core hours of operation are Mon-Fri from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across DCY divisions. Employees may begin as early as 7:00am & as late as 9:00am, based on supervisory approval. This position performs work on-site daily at DCY's office space.

'',''!*!

This role involves monitoring, evaluating, and supporting Medicaid-related projects and programs with a focus on populations served by Public Children's Services Agencies (PCSAs). Work is performed both independently and as part of cross functional teams. You will regularly collaborate with technical staff, policy experts, partner agencies, and stakeholders.

Key Activities You Can Expect in This Role

• Conduct complex statistical, financial, and program analyses, including reviewing and comparing federal and state regulations.
• Compile and interpret data from multiple health care and programmatic sources.
• Resolve issues related to medical service delivery and coverage for Medicaid recipients.
• Monitor managed care contracts to ensure compliance and develop performance based summaries.
• Use advanced databases and systems such as CCWIS, and Ohio Benefits to perform technical updates, process control file changes, and produce detailed reports.
• Provide consultative expertise, technical assistance, and training to internal and external stakeholders.
• Act as a liaison to agencies and divisions such as ODM, DODD, DYS, DCY''s Policy team, and IT.
• Coordinate activities among entities responsible for implementing Medicaid policy related to PCSA involved youth.
• Participate in committees, task forces, conferences, and workshops, including projects like the Multi System Youth Grant initiative.
• Reconcile complex enrollment and disenrollment records and respond to inquiries from consumers, providers, CDJFS, PCSAs, officials, and contractors.
• Prepare position papers, research documents, monitoring reports, and evaluation summaries.
• Use computer systems and online resources to gather information and generate spreadsheets, correspondence, and reports.
• Assist with reviewing, drafting, and implementing Medicaid rules, especially those affecting youth under age 21.
• Collaborate with IT teams to ensure policy changes are accurately reflected in statewide systems.
• Compile and maintain Medicaid policy manual content.
• Support the promulgation of Ohio Administrative Code rules by analyzing legislation, reviewing policy alignment, and working with stakeholders.

Pay Information

Unless required by legislation or union contract, starting salary will be step 1 of the salary range associated with this position. New hires advance to the next step in the range after 6 months and annually thereafter. Based on collective bargaining and legislative activity, there may be cost of living increases awarded annually. Additional longevity supplements begin after 5 years. The current wage progression for this position is in the table below.

Months of Employment

At Hire

6 months

18 months

30 months

42 months

54 Months

66 Months

78 Months

Pay Range

1199/13

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Hourly

$36.01

$37.75

$39.64

$41.53

$43.56

$45.72

$47.95

$50.37

Annual

$74,901

$78,520

$82,451

$86,382

$90,605

$95,098

$99,736

$104,770

Background Check Information

The final candidate selected for the position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant''s prior criminal convictions will be made before excluding an applicant from consideration.

Status of posted positions

You can check the status of your application online be signing into your profile and clicking the "My Jobpage" tab to view completed submissions and submission details. If you have questions other than your applications status, please direct them to DCY.HumanResources@childrenandyouth.ohio.gov.

'',''!*!

This role involves monitoring, evaluating, and supporting Medicaid-related projects and programs with a focus on populations served by Public Children's Services Agencies (PCSAs). Work is performed both independently and as part of cross functional teams. You will regularly collaborate with technical staff, policy experts, partner agencies, and stakeholders.

Key Activities You Can Expect in This Role

• Conduct complex statistical, financial, and program analyses, including reviewing and comparing federal and state regulations.
• Compile and interpret data from multiple health care and programmatic sources.
• Resolve issues related to medical service delivery and coverage for Medicaid recipients.
• Monitor managed care contracts to ensure compliance and develop performance based summaries.
• Use advanced databases and systems such as CCWIS, and Ohio Benefits to perform technical updates, process control file changes, and produce detailed reports.
• Provide consultative expertise, technical assistance, and training to internal and external stakeholders.
• Act as a liaison to agencies and divisions such as ODM, DODD, DYS, DCY''s Policy team, and IT.
• Coordinate activities among entities responsible for implementing Medicaid policy related to PCSA involved youth.
• Participate in committees, task forces, conferences, and workshops, including projects like the Multi System Youth Grant initiative.
• Reconcile complex enrollment and disenrollment records and respond to inquiries from consumers, providers, CDJFS, PCSAs, officials, and contractors.
• Prepare position papers, research documents, monitoring reports, and evaluation summaries.
• Use computer systems and online resources to gather information and generate spreadsheets, correspondence, and reports.
• Assist with reviewing, drafting, and implementing Medicaid rules, especially those affecting youth under age 21.
• Collaborate with IT teams to ensure policy changes are accurately reflected in statewide systems.
• Compile and maintain Medicaid policy manual content.
• Support the promulgation of Ohio Administrative Code rules by analyzing legislation, reviewing policy alignment, and working with stakeholders.

Pay Information

Unless required by legislation or union contract, starting salary will be step 1 of the salary range associated with this position. New hires advance to the next step in the range after 6 months and annually thereafter. Based on collective bargaining and legislative activity, there may be cost of living increases awarded annually. Additional longevity supplements begin after 5 years. The current wage progression for this position is in the table below.

Months of Employment

At Hire

6 months

18 months

30 months

42 months

54 Months

66 Months

78 Months

Pay Range

1199/13

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Hourly

$36.01

$37.75

$39.64

$41.53

$43.56

$45.72

$47.95

$50.37

Annual

$74,901

$78,520

$82,451

$86,382

$90,605

$95,098

$99,736

$104,770

Background Check Information

The final candidate selected for the position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant''s prior criminal convictions will be made before excluding an applicant from consideration.

Status of posted positions

You can check the status of your application online be signing into your profile and clicking the "My Jobpage" tab to view completed submissions and submission details. If you have questions other than your applications status, please direct them to DCY.HumanResources@childrenandyouth.ohio.gov.

'',''!*!

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.

'',''!*!

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.

'',''!*!

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

'',''!*!

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

'',''!*!

The Ohio Department of Children and Youth does not provide employment-based visa sponsorship.

All answers to the supplemental questions must be supported by the work experience/education provided on your civil service application. Attachments will not be considered as part of your application.

Selection devices such as a structured interview, proficiency instrument, and/or assessment may be required for this position. Applicants must demonstrate proficiency with a passing score of applicable selection device to be considered for this position. Regardless of a passing or failing score, all results will be maintained for 6 months. Applicant with a passing score will be retained and utilized for a 6-month period. Applicant with a failing score in the same position may not re-take the same selection device for a 6-month period.

Travel required, as needed. Must provide own transportation or in order to operate a state vehicle, you must have a valid driver's license.

'',''!*!

The Ohio Department of Children and Youth does not provide employment-based visa sponsorship.

All answers to the supplemental questions must be supported by the work experience/education provided on your civil service application. Attachments will not be considered as part of your application.

Selection devices such as a structured interview, proficiency instrument, and/or assessment may be required for this position. Applicants must demonstrate proficiency with a passing score of applicable selection device to be considered for this position. Regardless of a passing or failing score, all results will be maintained for 6 months. Applicant with a passing score will be retained and utilized for a 6-month period. Applicant with a failing score in the same position may not re-take the same selection device for a 6-month period.

Travel required, as needed. Must provide own transportation or in order to operate a state vehicle, you must have a valid driver's license.

'',''!*!

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.

'',''!*!

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.

'',''!*!

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.

'',''!*!

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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