Utilization Management Section Chief - RN (Medicaid Health Systems Administrator 2 - RN)

About the role

As the Utilization Management Section Chief - RN in the Office of Health Innovation & Quality, Ohio Department of Medicaid (ODM), you will work under the Bureau Chief of Clinical Operations and the clinical direction of ODM's Medical Directors. The position is located at Lazarus 4 in Columbus, Ohio (Franklin County).

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.

Responsibilities

• Working under the Bureau Chief of Clinical Operations and the clinical direction of ODM's Medical Directors.
• Provide oversight to the processes of identifying, managing, and tracking UM clinical operations, technology, quality, and regulatory oversight to advance the objectives of ODM.
• Manage two teams of nurses and oversee UM of vendor and managed care entities.
• Develop reports