Ohio medicaid comprehensive integrated care incentive program (cicip)
The Managed Care Department is responsible for developing and implementing the managed care strategies and objectives for the OSU Health System University Hospitals, The James, University Reference Labs and related entities
Job Summary
The Managed Care Department is responsible for developing and implementing the managed care strategies and objectives for the OSU Health System University Hospitals, The James, University Reference Labs and related entities.
This role leads the strategy, development, and negotiation of complex VBC arrangements across Medicare Advantage, Medicaid Managed Care, and Commercial payers.
The Senior Contract Specialist ensures all negotiated agreements adhere to managed care and regulatory standards, including documentation and audit readiness.
Matching Summary
The Managed Care Department is responsible for developing and implementing the managed care strategies and objectives for the OSU Health System University Hospitals, The James, University Reference Labs and related entities.
Skills & Requirements
Must-have
Value-based care (VBC) contracting
CMS and Ohio Medicaid programs
Ohio Medicaid Comprehensive Integrated Care Incentive Program (CICIP)
Financial modeling of VBC contracts
Payer-provider contract interpretation
Nice-to-have
Strong cross-functional collaboration
Influencing stakeholders at all levels
Ability to work under stress and deadlines
Key Requirements
Bachelor's Degree in Business Administration, Healthcare Admin, Finance, Public Health, Marketing or related field
4 years of relevant experience
3+ years of experience in managed care contracting, payer/provider analytics, or value-based care program management
Demonstrated experience with CMS VBC models and Ohio Medicaid managed care programs
In-depth knowledge of Ohio Medicaid’s CICIP structure, metrics, financial methodologies, and reporting