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Medicaid Services Manager
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Hamilton County, Ohio
Remote
$90,056 Salary, Full-Time
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Job Description
At Hamilton County Developmental Disabilities Services, we believe everyone deserves the opportunity to live a full and meaningful life. Our team makes that possible every day — and we're looking for people who want their work to matter. We are committed to building a team as diverse as the people we serve, where every member feels valued, supported, and set up to succeed. You'll thrive here if you: Are driven by purpose and find fulfillment in improving the lives of others Communicate clearly and compassionately — in writing and in person Want to grow within an organization that invests in its people and its community What we offer: Competitive Pay Starting salary is based on experience: $42.50/hr. ($80,112.50/yr) with no experience, up to $53.13/hr. ($100,000/yr) with 10+ years in the same role Salaried role paid bi-weekly Work-Life Balance 36.25-hour full-time work week Flexible scheduling and hybrid work-from-home options Starting vacation accrual of 3 weeks/year, with 1 week available immediately upon hire 3 personal days per year 15 sick days allocated upon hire; accrues at 15 days per year after year one with unlimited accrual Outstanding Benefits Medical, Dental, and Vision coverage; HRA available for those who opt out of medical coverage FREE medical care and prescriptions through Marathon Health Employer-paid life insurance Tuition reimbursement and Public Service Loan Forgiveness (PSLF) eligibility Wellness incentives and a robust Employee Assistance Program Ohio Public Employees' Retirement System (OPERS): 10% employee / 14% employer contribution Medicaid Services Manager A typical day for a Medicaid Services Manager begins with reviewing overnight data entries, waiver service updates, and activity in the Cost Projection Tool (CPT) and Payment Authorization of Waiver Services (PAWS) systems, along with addressing any urgent eligibility, authorization, or funding issues. Throughout the day, you may provide technical guidance to billing and benefits staff, participate in team and leadership meetings to resolve operational challenges, and collaborate with providers and external stakeholders to ensure fiscal accuracy and continuity of services. You may also lead staff training, support process improvement efforts, and respond to provider inquiries regarding funding, billing, or benefits. Every day brings a mix of problem-solving, collaboration, and leadership, with the shared goal of ensuring accurate service funding and improving outcomes for the individuals and families the agency serves. Job Duties (Summary): Lead and oversee the daily operations of the Funding Team, including service authorization and waiver funding processes. Supervise and support staff through coaching, training, performance management, and professional development. Monitor and ensure accuracy of funding data, service authorizations, payment systems, and related fiscal information. Collaborate with internal teams to resolve Medicaid eligibility, waiver enrollment, and funding-related issues. Analyze data and provide recommendations to support funding decisions, process improvements, and operational efficiency. Develop, implement, and maintain department policies, procedures, forms, and staff training materials. Coordinate funding and benefits activities to ensure seamless Medicaid and waiver enrollment and re-enrollment processes. Serve as a resource to providers and agency staff on service authorization, billing, and funding requirements. Build and maintain effective partnerships with providers to resolve authorization, utilization, and billing concerns. Participate in committees and improvement initiatives to enhance service quality, compliance, and operational effectiveness. Review and approve expenditures and monitor staffing schedules to support departmental operations. Ensure compliance with applicable Medicaid, waiver, and agency requirements. Perform additional duties as assigned.