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Director of Compliance & Performance Monitoring (Administrative Staff) - 20068603

Job Description - Director of Compliance & Performance Monitoring (Administrative Staff) - 20068603

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.


 Qualifications:

  • Preferred: Bachelors or Master’s in Business Administration, Public Administration,  Accounting, Finance, Organizational Leadership or related field. Experience overseeing operational compliance to include adherence to policy and procedure.

     

  • The ideal candidate for this position will possess a strong working knowledge of accounting principles, organizational policy, and quality assurance standards. Preference will be given to applicants who demonstrate experience with financial reporting and internal controls, as well as the ability to interpret and apply organizational policies and quality assurance practices within a compliance and performance monitoring environment. This expertise will support the unit’s efforts to maintain operational excellence, ensure contractual compliance, and promote continuous improvement across all monitored programs.

Major Worker Characteristics:
Knowledge of:  budgeting, accounting, management, labor relations, workforce planning, employee training & development, public relations, human relations, BWC & MCOs’ policies & standard operating procedures*; counseling; interviewing; business; state & federal law pertaining to PBMs & MCOs; vocational rehabilitation services*; operational policy/procedure development, quality assurance standards, SUPR* management reports; monitoring programs; leadership.

Skill in\: Medical bill adjudication software, MS Office, Data analytic software such as Tableau* or Cognos*.CoreSuite* and CAM*

Ability to:  exercise personal & sound business judgment in variety of business scenarios; deal with many complex variables & determine specific action; use statistical analysis; complete complex position papers; maintain accurate records; originate routine business letters reflecting standard &  non-standard policies & procedures; interview job applicants effectively; understand complex manuals & verbal instructions, technical in nature; prepare & deliver speeches before specialized audiences & general public; gather, collate & classify information about data, people or things; portray professional image & create friendly atmosphere as management staff member; maintain high degree of loyalty, trust & confidence.

(*) Developed after employment.

Unusual Working Conditions:

  • This position is overtime exempt.

  • THIS POSITION IS UNCLASSIFIED PERSUANT TO ORC 124.11(A)(9).

  • Position requires travel; therefore, persons occupying this position must provide their own transportation and/or legally operate a state-owned vehicle.

  • The final external applicant selected for this position will be required to submit to urinalysis prior to appointment to test for illegal drug use. An applicant with a positive test result will NOT be offered employment.

  • The final applicant for this position must submit to and pass an extensive background check by the Ohio State Patrol prior to appointment.

  • WEATHER ESSENTIAL EMERGENCY EMPLOYEE


A Little About Us:
With roughly 1,500 employees in 7 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.  
For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. 

Our Culture:
BWC is a dynamic organization that offers career opportunities across many different disciplines.  BWC employees strive to maintain an inclusive workplace.  We begin by being an equal opportunity employer.  Employees can participate in and lead employee resource groups, participate in online forums discussing society’s impact on our services and workplace, and learn about how different perspectives can improve leadership skills. 

Our Vision:
To transform BWC into an agile organization driven by customer success.

Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.

Our Core Values:
One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.

What our employees have to say:
BWC conducts an internal engagement survey on an annual basis.  Some comments from our employees include:

  • BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
  • I have worked at several state agencies and BWC is the best place to work.
  • Best place to work in the state and with a sense of family and support.
  • I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
  • I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.


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.


BWC’s core hours of operation are Monday-Friday from 8\:00am to 5\:00pm, however, daily start/end times may vary based on operational need across BWC departments.  Most positions perform work on-site at one of BWC’s seven offices across the state.  BWC offers flex-time work schedules that allow an employee to start the day as early as 7\:00am or as late as 8\:30am. Flex-time schedules are based on operational need and require supervisor approval.

What You’ll Be Doing:

  • Oversees operations of the Compliance & Performance Monitoring unit responsible for vocational rehabilitation regulatory, managed care organization (MCO) reporting, MCO compliance, Employer Substance Use Prevention and Recovery (SUPR) program compliance, Operational Quality Assurance, and Operational Policy.
  • Oversees Compliance management team’s administration of Annual Monitoring Plan which monitors & regulates performance of pharmacy rebate aggregators, Pharmacy Benefit Managers (PBMs), MCOs, and ensures operational quality standards and policies are maintained.
  • Creates and/or ensures monitoring plan, procedures, policies, quality assurance initiatives, and operational policy guidelines are carried out, identifies process improvements & recommends internal controls through issuance of Compliance Analysis Reports (CARs), Operational Quality Assurance reviews, and Operational Policy creation and updates.
  • Accesses & controls high-level confidential & legal documents & provides confidential advice to front-line departmental managers; advises Division Chief, directors, PBMs & MCOs regarding monitoring processes, operational quality, and policy matters.
  • Hires, promotes, disciplines, & terminates subordinate personnel as appropriate and/or necessary.
  • Performs other unclassified & fiduciary duties & functions as required (e.g., development & delivery of complex presentations related to monitoring BWC, PBM, MCOs, operational quality assurance, and operational policy, makes presentations to Chief & other BWC executive staff).
  • Makes presentations to Chief & other BWC executive staff regarding monitoring processes, operational quality, and policy matters.

 


EEO & ADA Statement:
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.

The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, pregnancy, or religion, please contact the ADA mailbox at\: [email protected].

Educational Transcripts:
For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.

All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.

Background Check:
Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.

The final applicant selected for this position will be required to submit to urinalysis prior to appointment to test for illegal drug use.  An applicant with a positive test result will NOT be offered employment.

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