Job Description

What You Will Do At ODM
Working Title: Fraud Referral and Deconfliction Coordinator

Office: Legal Counsel

Bureau: Program Integrity

Classification: Program Administrator 2 (PN:20036504)

Job Overview
The Ohio Department of Medicaid (ODM), Office of Legal Counsel, is seeking an experienced healthcare program administrator to join the Program Integrity team. As Fraud Referral and Deconfliction Coordinator, your responsibilities will include, but not be limited to:

Processing provider fraud referrals, deconflictions and Managed Care Plan attestations in the fraud referral and coordination system

Coordinating program integrity activities across the bureau

Organizing and managing regular meetings with Managed Care Plan Special Investigations Units (SIU) and Managed Care Program Integrity Group (MCPIG)

Participating in key meetings related to provider fraud referrals, provider suspension, and provider termination

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