What are the responsibilities and job description for the Network Oversight Manager (Medicaid Health Systems Administrator 1) position at Ohio Department of Medicaid?
What You Will Do At ODM
Office: Managed Care
Bureau: Network Management & Operations
Classification: Medicaid Health Systems Administrator 1 (PN: 20045493)
Job Overview
As the Network Oversight Manager in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include:
Or 12 months experience as a Medicaid Health Systems Specialist, 65293.
Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Dec 3, 2025, 4:59:00 AM
Work Location
Lazarus 5
Primary Location
United States of America-OHIO-Franklin County-Columbus
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
Collaboration, Innovation, 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:
Office: Managed Care
Bureau: Network Management & Operations
Classification: Medicaid Health Systems Administrator 1 (PN: 20045493)
Job Overview
As the Network Oversight Manager in the Office of Managed Care, Ohio Department of Medicaid (ODM), your responsibilities will include:
- Provider Network Oversight lead for the Medicare-Medicaid plans (MMPs) ensuring compliance with the Code of Federal Register (CFR), Ohio Administrative Code(OAC), and Provider Agreement (PA)
- Monitoring network adequacy through reporting, provider updates, and compliance reviews
- Evaluating provider terminations and changes to assess impact to provider network
- Coordinating and facilitating monthly provider group meetings between the Ohio Department of Medicaid and Managed Care Entities
- Managing and updating key provider network deliverables and reporting templates
- Ensuring compliance with current Medicaid and Medicare policy, procedures, rules, and regulations as required
- Supporting the development of network adequacy methodologies and contributing to annual reporting and strategic planning
- Acting as liaison between the Office of Managed Care and internal and external stakeholders
- Identifying and escalating provider network issues to leadership and recommending solutions to maintain or improve member access to care
Or 12 months experience as a Medicaid Health Systems Specialist, 65293.
- Or equivalent of Minimum Class Qualifications for Employment noted above.
Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication
Organization
Medicaid
Agency Contact Name and Information
HumanResources@medicaid.ohio.gov
Unposting Date
Dec 3, 2025, 4:59:00 AM
Work Location
Lazarus 5
Primary Location
United States of America-OHIO-Franklin County-Columbus
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
Collaboration, Innovation, 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 : $39