Ohio Benefits Program Specialist - PN 20096292 (Medicaid Health Systems Specialist)

Who We Are 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. What You'll Do Office : Managed Care Bureau: Member Services Classification: Medicaid Health Systems Specialist (PN: 20096292) Job Overview : As the Ohio Benefits Program Specialist in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include: Analyze reported system (Ohio Benefits - OB, Fiscal Intermediary - FI, and Provider Network Management - PNM) problems from providers to determine impact on Medicaid eligibility workflows, and priority level for resolution. Evaluate the impact of system issues and changes on eligibility determinations, provider interactions, and downstream data sharing processes. Collaborate with internal program areas to ensure accurate representation of Medicaid policy within system operations. Communicate regularly with system vendors, providing detailed issue descriptions, replication steps, and supporting documentation to facilitate timely troubleshooting and defect resolution. Participate in vendor meetings, technical workgroups, and system review sessions to support issue resolution and progress monitoring. Review vendor proposed solutions, design documents, and system updates to ensure alignment with Medicaid rules, policy intent, and operational needs. Monitor, track, and document Ohio Benefits system defects, enhancements requests, and performance issues using established issue tracking tools and processes. Assist in user acceptance testing (UAT) by developing test scenarios, validating fixes, and confirming successful implementation prior to production release. Prepare reports, summaries, and status updates for leadership, documenting issue trends, resolution timelines, risks, and recommended actions. Additional Information The Ohio Department of Medicaid does not provide employment-based visa sponsorship. Compensation is as listed on the posting unless required by legislation or union contract. The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full-time, if selected. 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.