Medicaid Policy & Fee-For-Service (FFS) Operations is responsible for developing and maintaining Medicaid policies for access to services. The unit maintains FFS operations and the Open Card healthcare system for over 120,000 Medicaid members, provides direct oversight for FFS contracts, maintains FFS rate schedules, and collaborates with community partners to identify gaps in policy and services. Medicaid is transforming FFS to create a statewide, person-centered system of care to aid in eliminating health inequities by 2030, including convening the Lived Experience Advisory Panel (LEAP) comprised of FFS members, their families, and community advocates.
The purpose of this position is to provide financial analysis, interpretation, and calculation of payments supporting the establishment of payment rates and methodologies. Findings and analyses will be used to advise management on fiscal matters related to the fiscal operations of HRSN services. You will analyze care coordination rates, compare rates with other payers, leverage Fee Schedule sources, and engage external partners to establish statewide HRSN payment methodologies. Responsibilities include coordinating with Business Information Systems on needed IT system changes to support financial disbursement and supporting adoption of information exchange platforms to develop a statewide care coordination community.
Additional responsibilities include supporting the establishment of minimum rates for HRSN services, payment methodologies, provider participation incentives, and contracting processes with Community-Based Organizations (CBOs). This position will support HRSN-based minimum rate changes in Oregon Administrative Rules (OARs) and contracts; and analyze and implement required changes in FFS and Coordinated Care Organization (CCO) contracts.
Minimum Qualifications:
Five years of progressively responsible experience that included the preparation, analysis, and administration of a budget or fiscal system.
OR, five years of professional-level experience in accounting, fiscal auditing, management or program analysis. Experience must have included modeling, forecasting and analyzing fiscal information.
OR, successful completion of the Department of Administrative Services Budget and Management Public Administrative Trainee Program.
Desired Attributes:
Benefits of Joining Our Team
Apply online at oregonjobs.org using job number REQ-185771
Application Deadline: 08/27/2025
Salary Range: $5,325 - $8,148
The Oregon Health Authority is at the forefront of lowering and containing costs, improving quality and increasing access to health care in order to improve the lifelong health of Oregonians. OHA is overseen by the nine-member citizen Oregon Health Policy Board working towards comprehensive health reform in our state.
Vision:
A healthy Oregon
Mission:
Ensuring all people and communities can achieve optimum physical, mental, and social well-being through partnerships, prevention, and access to quality, affordable health care.