Managed Care/Provider Audit Manager (External Audit Manager 1)

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.

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 Will Do at ODM:

Office: Legal Counsel

Bureau: Program Integrity

• Classification: External Audit Manager 1 (PN 20100479)

Job Overview:

As a Managed Care/Provider Audit Manager in the office of Legal Counsel/Program Integrity, Ohio Department of Medicaid (ODM), your responsibilities will include:

• Supervising lower-level external auditors (establishing unit goals, assigning work, providing direction, monitoring and evaluating performance, recommending discipline, recommending applicants to hire, approve/deny leave requests, conduct staff meetings)
• Working closely with the Medicaid Managed Care program area to assess risks, measure performance, and validate information related to the Managed Care Plans (MCPs) and their network providers
• Conducting final review of all audit work papers, memos, overpayments letters, proposed exceptions, adjustments, and reclassifications for MC & Providers South unit
• Conferring with staff concerning problems and emphasis of audits
• Developing and implementing policies, procedures & standards for units in accordance with section goals

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• 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)

*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.

Completion of undergraduate core coursework in accounting, business administration, computer science or related field; 5 yrs. exp. in auditing or accounting which must have included 30 mos. auditing exp. in accordance with auditing standards or in accordance with prescribed management policies &/or procedures as specified on agency position description; 1 yr. exp. or 1 yr. trg. in supervisory principles/techniques. 

• Or 7 yrs. exp. in auditing, accounting which must have included 42 mos. auditing exp. in accordance with auditing standards or in accordance with prescribed management policies &/or procedures as specified on agency position description; 1 yr. exp. or 1 yr. trg. in supervisory principles/techniques.
• Or 12 mos. exp. as External Audit Supervisor, 66465.
• Or equivalent of Minimum Class Qualifications for Employment noted above.Job Skills: Auditing
• Technical Skills: Auditing, Program Management, Compliance Enforcement
• Professional Skills: Collaboration, Establishing Relationships, Written Communication, Verbal Communication, Analyzation, 
• Compensation is as listed on the posting unless required by legislation or union contract.
• This position is overtime exempt.

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.

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.