Self-Direction Program Manager – Ohio at Elevance Health

Mason, Ohio, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medicaid Managed CareIndustries

Requirements

BA/BS degree and minimum of 5 years external client facing experience in program/project management (or equivalent combination of education and experience)
Reside within commuting distance from an OH Pulse Point location (candidates not within reasonable commuting distance will not be considered unless accommodation granted)

Responsibilities

Development and ongoing management of the OhioMyCare self-direction program available HCBS waivers
Daily management and oversight of Ohio self-direction program operations, including enrollment, eligibility, FMS operations, claims payment, member communications, and coordination of services for enrollees
Oversight of contracts with financial management services entities and conducting routine audits of key performance indicators and contract adherence
Serve as liaison between the MCO, member, FMS, and state
Support business strategies through an integrated portfolio of external client facing projects or initiatives
Collaborate with the LTSS COE as part of the larger enterprise/regional external client facing program
Manage and coordinate the development, approval, implementation, and compliance of ongoing external client facing programs; develop program budget; ensure program meets stated objectives; provide subject matter expertise in response to day-to-day external client facing business issues
Research applicable self-direction practices and remain aware of industry trends
Coordinate training related to state self-direction programs; develop program success measures and perform periodic assessments of program success

Skills

Program Management

HCBS Waivers

Contract Oversight

Audits

Stakeholder Liaison

LTSS

Enrollment Management

Claims Payment

Member Communications

FMS Operations

Self-Direction Programs

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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