What are the responsibilities and job description for the Fraud Referral and Deconfliction Coordinator (Program Administrator 2) position at Ohio Department of Medicaid?
What You Will Do At ODM
Working Title: Fraud Referral and Deconfliction Coordinator
Office: Legal Counsel
Bureau: Program Integrity
Classification: Program Administrator 2 (PN:20036504)
Job Overview
The Ohio Department of Medicaid (ODM), Office of Legal Counsel, is seeking an experienced healthcare program administrator to join the Program Integrity team. As Fraud Referral and Deconfliction Coordinator, your responsibilities will include, but not be limited to:
Technical Skills: Program Management
Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication, Organizing and Planning
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Jan 13, 2026, 9:59:00 PM
Work Location
50 W Town St
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$32.35/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Unclassified
Union
Exempt from Union
Primary Job Skill
Program Management
Technical Skills
Program Management
Professional Skills
Collaboration, Innovation, Organizing and Planning, Verbal Communication, Written Communication, Confidentiality, Continuous Improvement
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.
Responsibilities
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:
Working Title: Fraud Referral and Deconfliction Coordinator
Office: Legal Counsel
Bureau: Program Integrity
Classification: Program Administrator 2 (PN:20036504)
Job Overview
The Ohio Department of Medicaid (ODM), Office of Legal Counsel, is seeking an experienced healthcare program administrator to join the Program Integrity team. As Fraud Referral and Deconfliction Coordinator, your responsibilities will include, but not be limited to:
- Processing provider fraud referrals, deconflictions and Managed Care Plan attestations in the fraud referral and coordination system
- Coordinating program integrity activities across the bureau
- Organizing and managing regular meetings with Managed Care Plan Special Investigations Units (SIU) and Managed Care Program Integrity Group (MCPIG)
- Participating in key meetings related to provider fraud referrals, provider suspension, and provider termination
- Tracking Managed Care Plan SIU and external stakeholders’ activities
- Tracking and analyzing key program integrity performance metrics (e.g., fraud/abuse referrals) are being met by Managed Care Plans
- Organizing and supporting Home Health Fraud work group
- Providing oversight for contract vendors, deliverables, and contract costs
- Performs other duties and administrative functions as assigned
- Or completion of undergraduate core program in business administration, management science or public administration; 2 yrs. trg. or 2 yrs. exp. in supervisory, administrative &/or managerial position.
- Or completion of undergraduate core program in academic field commensurate with program area to be assigned per approved Position Description on file; 2 yrs. trg. or 2 yrs. exp. in supervisory, administrative &/or managerial position or staff position involving planning, research &/or policy/procedure development.
- Or 1 yr. exp. as Program Administrator 1, 63122.
- Or equivalent of Minimum Class Qualifications For Employment noted above
Technical Skills: Program Management
Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication, Organizing and Planning
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Jan 13, 2026, 9:59:00 PM
Work Location
50 W Town St
Primary Location
United States of America-OHIO-Franklin County-Columbus
Compensation
$32.35/hour
Schedule
Full-time
Work Hours
8:00 am - 5:00 pm
Classified Indicator
Unclassified
Union
Exempt from Union
Primary Job Skill
Program Management
Technical Skills
Program Management
Professional Skills
Collaboration, Innovation, Organizing and Planning, Verbal Communication, Written Communication, Confidentiality, Continuous Improvement
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.
Responsibilities
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.
Salary : $32