Complex Medical Help Finance Supervisor (Health Finance Resource Specialist Supervisor- 20014052)

The Health Finance Resource Specialist Supervisor will work under the direction of Complex Medical Help (CMH) administrator to supervise and evaluate programmatic functions of the Bureau of Maternal, Child and Family Health, Complex Medical Help Program. This position will supervise staff, to include approving leave requests, conducting employee performance evaluations and maintain time and attendance records. Additional duties include:

• Evaluates program policies & makes recommendations regarding procedures to streamline financial eligibility determination & enhance the quality & number of referrals of CMH applicants to other third-party programs (e.g., Healthy Start, Supplemental Security Income, Women Infant & Children, Children & Family Health Service, other Ohio Department of Job & Family Services (ODJFS) programs.
• Supervises staff who review family financial, insurance, medical & demographic documentation in order to determine CMH financial eligibility, identifies families with potential catastrophic costs for further follow-up & makes appropriate referrals.
• Monitors compliance of hospitals, local health departments & other service providers regarding knowledge & use of appropriate CMH financial eligibility guidelines & third-party referral mechanisms.
• Provides training to CMH staff, service providers, families & other agencies regarding CMH program eligibility requirements & resources available through other third-party programs.
• Coordinates, monitors & implements program to process financial appeals, including review of complex case reconsiderations & formal hearing requests & makes appropriate recommendations.
• Sets unit goals & objectives & establishes performance standards for quality & quantity of work.
• Prepares reports, drafts administrative rules, policies & procedures & makes recommendations to Bureau Chief & Nursing Administrator &/or supervisor.
• Reviews selected samples & prepares summary reports regarding characteristics of population served, cost share usage, financial eligibility formula revisions, third party referral patterns & other information as required.
• Prepares annual eligibility criteria for program operations.
• Prepares program operational guidelines for annual update of financial eligibility criteria.
• Makes recommendations regarding unit's budget requirements.
• Represents CMH at meetings with local service providers & establishes relationships with county departments of ODJFS, CMH providers & others as necessary & drafts correspondence to families, providers, legislators, attorneys & others as directed by supervisor.

Position Qualifications:

36 mos. trg. or 36 mos. exp. in determining eligibility &/or facilitating appropriate resources/program referrals of clients for governmental assistance for financial or health programs (e.g., Medicaid; social security; Temporary Assistance for Needy Families (i.e. TANF); general assistance).

• Or completion of undergraduate core program in social or behavioral sciences, humanities or related field AND 12 mos. trg. or 12 mos. exp. in determining eligibility &/or facilitating appropriate resources/program referrals of clients for governmental assistance for financial or health programs (e.g., Medicaid; social security; Temporary Assistance for Needy Families (i.e. TANF); general assistance).
• Or 24 mos. exp. as Health Financial Resource Specialist, 17221.
• Or equivalent of Minimum Class Qualifications For Employment noted above.

Job Skills: Accounting and Finance

Technical Skills: Budgeting, Program management, Public relations

Professional Skills: Analyzation, Collaboration

Educational Transcript Requirements:

Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript prior to receiving a formal offer of employment. Failure to provide transcripts within five (5) working days of being requested will cause the applicant to be eliminated from further consideration.

Please note that a transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree.