Provider Quality Assurance Manager (25000806)
Provider Quality Assurance Manager
(25000806)
Organization: Aging
Agency Contact Name and Information: Renee' Norris
Unposting Date: Oct 30, 2025, 9:59:00 PM
Work Location: James A Rhodes Office Tower 30 East Broad Street Columbus 43215-3430
Primary Location: United States of America-OHIO-Franklin County
Compensation: $39.22 to $43.68
Schedule: Full-time
Work Hours: 8:00 AM to 5:00 PM
Classified Indicator: Classified
Union: Exempt from Union
Primary Job Skill: Health Administration
Technical Skills: Operations, Regulatory Compliance, Customer Service
Professional Skills: Collaboration, Results Oriented, Verbal Communication, Written Communication
Agency Overview
About Us
The Ohio Department of Aging (AGE) is a cabinet-level agency within the executive branch of the Ohio state government. The director of AGE is a member of the Governor's cabinet, serving as principal advisor and advocate for 2.8 million older adults and their families. Through services, supports, and activities that cover a wide spectrum of issues, AGE strives to achieve its mission to foster sound public policy, research, and initiatives that benefit older Ohioans.
AGE is the federally designated agency responsible for developing and administering multi-year state plans that advocate for, and provide assistance to, older Ohioans and their families. In addition to the centralized functions, the agency designates and contracts with community providers and a network of 12 Area Agencies on Aging, who manage a wide array of federal and state-funded supportive services. These services assist older adults to live as independently as possible; promote healthy aging and active community involvement; and support family members in their vital care giving role.
To promote the agency's vision of Ohio - the best place to age in the nation, AGE actively collaborates with consumers, stakeholders from key associations, government, and the public. The independent Office of the State Long-Term Care Ombudsman and the Board of Executives of Long-Term Services and Supports are also located within AGE.
Our core values are:
Promote Independence- Provide resources that foster independence and autonomy throughout the lifespan.
Empower Communities- Deliver sustainable, relevant solutions that empower communities to act within the best interest of their elders.
Challenge Ageism- Promote new perspectives of aging that challenge the traditional declinist narrative.
Advocate for Excellence- Advocate with and for Ohio's elders to ensure their voices are heard and their needs are met.
Engage in Innovation- Engage the aging network by staying innovative, flexible, and attentive to the evolving needs of our partners and stakeholders.
To learn more about the Ohio Department of Aging and our programs visit our website.
About the Division
The Division for Community Living (DCL) develops and manages a comprehensive and coordinated system of community services for seniors and individuals with disabilities. Their pre-admission review and long-term care consultation program facilitates consumer access to available options. Staff develops and furnishes operational oversight of services and programs funded through home and community-based services (HCBS) as well as through state funds and grants. Some of these programs include PASSPORT, the Assisted Living Waiver program, and Program for All-Inclusive Care for the Elderly (PACE).
Job Duties
About the Role
AGE is looking for a highly motivated and talented individual to join the Division of Community Living (DCL) as the Provider Quality Assurance Manager. DCL manages home and community-based services (HCBS) for seniors and younger adults with disabilities. These services are accessed through the Aging and Disability Network and funded by Medicaid, state funds, and grants.
The PASSPORT Waiver program and the Assisted Living Waiver program are two examples of HCBS services. Highly-qualified providers are needed to care for and serve the program participants. The Provider Quality Assurance Manager will serve as a lead worker that ensures HCBS providers provide quality of care.
The job duties of this position include but are not limited to:
Formulate and implement policies, procedures, legislative rules, and practices to continue and/or enhance the quality of care delivered by HCBS providers;
Leads efforts with other state agencies on HCBS providers;
Research, review, and remedy claims issues in collaboration with AGE internal staff and ODM;
Conduct audits (desk and on-site) of providers;
Oversee administration of standard disciplinary action notices and, under minimal oversight, administer disciplinary action notices for the more complex cases.
For more in-depth job duties, please click here to view the position description.
Why Work for the State of Ohio
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
Qualifications
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).
-Or 12 months experience has Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure, if required. Note: education & experience is to be commensurate with approved position description on file. -If position oversees assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery, incumbent must also have current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code.
-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.
Job Skills: Health Administration
Provider Quality Assurance Manager
(25000806)
Organization: Aging
Agency Contact Name and Information: Renee' Norris
Unposting Date: Oct 30, 2025, 9:59:00 PM
Work Location: James A Rhodes Office Tower 30 East Broad Street Columbus 43215-3430
Primary Location: United States of America-OHIO-Franklin County
Compensation: $39.22 to $43.68
Schedule: Full-time
Work Hours: 8:00 AM to 5:00 PM
Classified Indicator: Classified
Union: Exempt from Union
Primary Job Skill: Health Administration
Technical Skills: Operations, Regulatory Compliance, Customer Service
Professional Skills: Collaboration, Results Oriented, Verbal Communication, Written Communication
Agency Overview
About Us
The Ohio Department of Aging (AGE) is a cabinet-level agency within the executive branch of the Ohio state government. The director of AGE is a member of the Governor's cabinet, serving as principal advisor and advocate for 2.8 million older adults and their families. Through services, supports, and activities that cover a wide spectrum of issues, AGE strives to achieve its mission to foster sound public policy, research, and initiatives that benefit older Ohioans.
AGE is the federally designated agency responsible for developing and administering multi-year state plans that advocate for, and provide assistance to, older Ohioans and their families. In addition to the centralized functions, the agency designates and contracts with community providers and a network of 12 Area Agencies on Aging, who manage a wide array of federal and state-funded supportive services. These services assist older adults to live as independently as possible; promote healthy aging and active community involvement; and support family members in their vital care giving role.
To promote the agency's vision of Ohio - the best place to age in the nation, AGE actively collaborates with consumers, stakeholders from key associations, government, and the public. The independent Office of the State Long-Term Care Ombudsman and the Board of Executives of Long-Term Services and Supports are also located within AGE.
Our core values are:
Promote Independence- Provide resources that foster independence and autonomy throughout the lifespan.
Empower Communities- Deliver sustainable, relevant solutions that empower communities to act within the best interest of their elders.
Challenge Ageism- Promote new perspectives of aging that challenge the traditional declinist narrative.
Advocate for Excellence- Advocate with and for Ohio's elders to ensure their voices are heard and their needs are met.
Engage in Innovation- Engage the aging network by staying innovative, flexible, and attentive to the evolving needs of our partners and stakeholders.
To learn more about the Ohio Department of Aging and our programs visit our website.
About the Division
The Division for Community Living (DCL) develops and manages a comprehensive and coordinated system of community services for seniors and individuals with disabilities. Their pre-admission review and long-term care consultation program facilitates consumer access to available options. Staff develops and furnishes operational oversight of services and programs funded through home and community-based services (HCBS) as well as through state funds and grants. Some of these programs include PASSPORT, the Assisted Living Waiver program, and Program for All-Inclusive Care for the Elderly (PACE).
Job Duties
About the Role
AGE is looking for a highly motivated and talented individual to join the Division of Community Living (DCL) as the Provider Quality Assurance Manager. DCL manages home and community-based services (HCBS) for seniors and younger adults with disabilities. These services are accessed through the Aging and Disability Network and funded by Medicaid, state funds, and grants.
The PASSPORT Waiver program and the Assisted Living Waiver program are two examples of HCBS services. Highly-qualified providers are needed to care for and serve the program participants. The Provider Quality Assurance Manager will serve as a lead worker that ensures HCBS providers provide quality of care.
The job duties of this position include but are not limited to:
Formulate and implement policies, procedures, legislative rules, and practices to continue and/or enhance the quality of care delivered by HCBS providers;
Leads efforts with other state agencies on HCBS providers;
Research, review, and remedy claims issues in collaboration with AGE internal staff and ODM;
Conduct audits (desk and on-site) of providers;
Oversee administration of standard disciplinary action notices and, under minimal oversight, administer disciplinary action notices for the more complex cases.
For more in-depth job duties, please click here to view the position description.
Why Work for the State of Ohio
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
Qualifications
Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).
-Or 12 months experience has Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure, if required. Note: education & experience is to be commensurate with approved position description on file. -If position oversees assessment or reassessment of clinical appropriateness of services &/or payment policies &/or related issues in regards to Medicaid health services delivery, incumbent must also have current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code.
-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.
Job Skills: Health Administration
Job ID: 498195931
Originally Posted on: 10/26/2025
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