Managed Care Rate Setting Healthcare Manager (Medicaid Health Systems Administrator 1)
DasstateohColumbus, Ohio, United States
Posted January 12, 2026
Full Time
About the Company
Dasstateoh, the Ohio Department of Administrative Services (DAS), delivers centralized, high-quality services to state agencies, boards, commissions, local governments, and universities. With over 40 program areas, DAS supplies a broad portfolio that includes information technology, procurement, human resources, real-estate management, payroll, printing, mail, and policy administration. The agency differentiates itself through innovative, cost-effective solutions, continuous process improvement, and a strong commitment to diversity and equal access to the workforce. By fostering collaboration across all program areas, Dasstateoh helps Ohio’s government operate more efficiently, transparently, and responsively.
Job Description
The Ohio Department of Medicaid (ODM) is seeking an experienced healthcare administrator to join the Managed Care Rate Setting (MCRS) team to assist with managing and administering general provisions of the Ohio Medicaid Program.
Requirements
- Serving as liaison between the State’s seven Managed Care Organizations (MCOs), the State’s actuary, and internal stakeholders in the development and administration of MMC capitation rates
- Interfacing with internal stakeholders, along with the State’s actuary, to monitor MCO financial performance
- Ensuring compliance with CMS reporting requirements such as submission of MMC capitation rate certifications, amendments, MLR reporting, and preprints
- Managing and validating the loading of MMC capitation rates into the State’s financial payment system
- Monitoring healthcare expense data
- Identifying and tracking Medicaid program changes impacting premium rate calculations and identifying changes in budget estimates
- Managing the reconciliation of various program initiatives and facilitating the entry, processing, payment, and/or recoupment of funds, by program and plan, respectively
- Monitoring and responding to inquiries from plans, providers, legislative requests, and constituency groups
Benefits
- 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)