Direct Enrollment Supervisor (Medicaid Health Systems Administrator 1)

Direct Enrollment Supervisor (Medicaid Health Systems Administrator 1) (2500056L)

Direct Enrollment Supervisor (Medicaid Health Systems Administrator 1)

(2500056L)

Organization: Medicaid

Agency Contact Name and Information: ...

Unposting Date: Jul 21, 2025, 9:59:00 PM

Work Location: Lazarus 4 50 West Town Street Columbus 43215

Primary Location: United States of America-OHIO-Franklin County

Compensation: $39.22/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, Leading Others, 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.

Job Duties

What You Will Do at ODM:

Office: Operations

Bureau: Business Operational Support

Classification: Medicaid Health Systems Administrator 1 (PN 20045501)

Job Overview:

As the Direct Enrollment Supervisor, your responsibilities will include:

Managing Medicaid eligibility operations for key interagency initiatives, including:

Breast and Cervical Cancer Project (Ohio Department of Health)

Pre-Release and Inpatient Hospitalization programs (Department of Rehabilitation and Correction, and Department of Youth Services

Supervising staff responsible for making Medicaid eligibility determinations in the Ohio Benefits system

Overseeing the management of ODM's caseload within the Ohio Benefits system

Ensuring accurate and timely eligibility determinations to support consumer access to care and reduce recidivism

Managing the Direct Reimbursement Program, including claim processing and reimbursement for out-of-pocket services

Reviewing and interpreting rule and policy changes from partner state agencies (Department of Rehabilitation and Correction, Department of Youth Services, and Department of Health)

Recommending and implementing updates to ODM's policies and procedures based on changes in Ohio Administrative Code (OAC)

Collaborating with internal and external stakeholders to ensure alignment and compliance across interagency initiatives

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 mos. exp. 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 has Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure, if required. Note: education & experience is to be commensurate with approved position description on file. -If position oversees assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery, incumbent must also have current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code.

-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