Top 62 Managed care specialist Jobs in Columbus

Managed Care Contract Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid holidays
- Health insurance
7d
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
Quick Apply
3d
Infrastructure Specialist 3 (20044518)
State of Ohio - Environmental Protection Agency —Columbus, OH
- $41.81 - $61.49 an hour
- Full-time
- Background check
- Computer Science
- Computer literacy
- Paid holidays
- Health insurance
6d
WC Claims Specialist (PN: 20068419, 20068729, 20069075, 20069106 & 20069204)
State of Ohio - Workers' Compensation —Columbus, OH
- $26.54 - $34.53 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Health insurance
2d
LPCC / LISW / IMFT Trauma Therapist (Hybrid)
Highlife Recovery —Columbus, OH
- $68,000 - $85,000 a year
- Choose your own hours
- Hybrid work
- LMFT
- Psychiatry
- Pass drug screening
- 401(k)
- Paid time off
23h
Specialist, Utilization Review
Columbus Springs East —Columbus, OH
- Full-time
- CPR Certification
- Management
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
Talent Acquisition Specialist
MARYHAVEN,INC —Columbus, OH
- Full-time
- Bachelor's degree
- Organizational skills
- 1 year
- Paid holidays
- Health insurance
Quick Apply
Client Insurance Specialist
Integrated Services for Behavioral Health —Columbus, OH
- $20.97 - $24.56 an hour
- Hybrid work
- Mid-level
- Organizational skills
- 2 years
- Disability insurance
- Health insurance
Quick Apply
Health Innovation Research Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid holidays
- Health insurance
10d
Referral Specialist
Equitas Health, Inc. —Columbus, OH
- $18.13 - $21.78 an hour
- Weekends as needed
- 3 years
- Administrative experience
- High school diploma or GED
- Paid holidays
- Dental insurance
Quick Apply
National Customer Service Specialist (Monday - Friday 9:00AM - 5:00PM)
STG Intermodal Inc —Dublin, OH
- Monday to Friday
- Mid-level
- High school diploma or GED
- Communication skills
1d
Prior Authorization Specialist
WSD —Westerville, OH
- $18 - $25 an hour
- Part-time
- Medical office experience
- HIPAA
- Mid-level
Quick Apply
9d
Outreach Engagement Specialist: part-time/weekends
MARYHAVEN,INC —Columbus, OH
- Part-time
- Mid-level
- Bachelor's degree
- Experience equivalent to degree accepted
- Continuing education credits
- Paid holidays
Quick Apply
Credentialing Program Manager
OhioHealth —Dublin, OH
- Full-time
- Hospital
- Customer service
- Research
Supply Chain Solutions Specialist
BLACKHAWK INDUSTRIAL OPERATING CO —Columbus, OH
- $20 - $27 an hour
- Full-time
- English
- Windows
- High school diploma or GED
- Health savings account
- AD&D insurance
Quick Apply
Long-Term Care Rate Setting Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Analysis skills
- Driver's License
- Travel
- Paid holidays
- Health insurance
20h
Case Records Specialist
NATIONAL YOUTH ADVOCATE PROGRAM —Columbus, OH
- $20 an hour
- Online Application
- Clean driving record
- Word processing
- Office
- Paid holidays
- Health insurance
Quick Apply
7d
Specialist, Strategic Sourcing
US AMR-Jones Lang LaSalle Americas, Inc. —Columbus, OH
- $93,000 - $115,000 a year
- Online Application
- Remote
- Background check
- Microsoft Excel
- Microsoft Outlook
- Paid parental leave
- Paid holidays
Quick Apply
Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Columbus, OH
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Writing skills
- Analysis skills
- Health insurance
Credentialing Program Manager - Dublin
OhioHealth —Dublin, OH
- Part-time
- Hospital
- Customer service
- Research

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Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

State of Ohio - Medicaid -
Columbus, OH

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Job Details

Full-time
$40.40 an hour
7 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance
Loan forgiveness
Life insurance

Qualifications

Legislative analysis
Health policy analysis
Health data analysis
Finance
Managed care organization experience
Healthcare Administration
Mid-level
Contract management experience in healthcare
Social Sciences
Public Administration
Medicaid health insurance
Analysis skills
Driver's License
Policy & process development
Compliance management
Budget planning
Public Health
Continuous improvement
Legislation
Project management experience in healthcare
Policy research projects
Contracts
Medicaid
Budget management in healthcare
Healthcare policy development
1 year
Project contract management
Business
Communication skills
Policy Development

Full Job Description

What You Will Do At ODM:

Office: Managed Care

Bureau: Contract Management & Compliance

Classification: Medicaid Health Systems Administrator 1 (PN: 20089575)

Job Overview:

As the Managed Care Contract Manager in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include:

Managing program information and conducting analyses to inform and direct policy changes and updates
Conducting evaluations for managed care plans
Performing research and answering questions related to legislative and policy initiatives such as implementation and ongoing assessment of new programs, populations and/or initiatives
Leading on managed care related contract issues, implementations, and targeted reviews
Working with the Managed Care plans to identify areas of concern and provide technical assistance as needed.
Reviewing and approving submitted reports and deliverables outlined in the Managed Care Provider Agreements
Communicating any compliance actions to the assigned Managed Care Plans

There are 4 MyCare Plans and 7 Managed Care Organizations (MCOs) that you will be working with.

MyCare Plans:

Anthem Blue Cross and Blue Shield
Buckeye Health Plan
CareSource
Molina HealthCare of Ohio, Inc.

Managed Care Organizations (MCOs)

AmeriHealth Caritas Ohio, Inc.
Anthem Blue Cross and Blue Shield
Buckeye Health Plan
CareSource
Humana Healthy Horizons in Ohio
Molina HealthCare of Ohio, Inc.
UnitedHealthcare Community Plan

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 (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.

Qualifications

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 data base 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

Supplemental Information

Supplemental Information:

Compensation is as listed on the posting unless required by legislation or union contract.

This positions is overtime exempt.

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.

Candidates selected for an interview will be required to complete a written assessment as part of the interview process.

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.

Apply Now

Refine Your Search

managed care specialist jobs in columbus

Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

Utilization Management Specialist

Infrastructure Specialist 3 (20044518)

WC Claims Specialist (PN: 20068419, 20068729, 20069075, 20069106 & 20069204)

LPCC / LISW / IMFT Trauma Therapist (Hybrid)

Specialist, Utilization Review

Talent Acquisition Specialist

Client Insurance Specialist

Health Innovation Research Manager (Medicaid Health Systems Administrator 1)

Referral Specialist

National Customer Service Specialist (Monday - Friday 9:00AM - 5:00PM)

Prior Authorization Specialist

Outreach Engagement Specialist: part-time/weekends

Credentialing Program Manager

Supply Chain Solutions Specialist

Long-Term Care Rate Setting Manager (Medicaid Health Systems Administrator 1)

Case Records Specialist

Specialist, Strategic Sourcing

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Credentialing Program Manager - Dublin

I want to receive the latest job alert for managed care specialist in columbus

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