IO Program Coordinator II

Agency/Division Information  

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office.  

Position Purpose  

IO Program Coordinator II plays a critical role in supporting the Oklahoma Health Care Authority's mission by ensuring efficient and effective administration of SoonerCare/Insure Oklahoma and other Medicaid programs. This position is responsible for resolving member, employer and agent inquiries, managing member enrollments, processing invoices and employer documents, processing income documents and maintaining compliance with program policies. The role requires strong communication skills, attention to detail, and the ability to navigate complex program guidelines, all while maintaining a high standard of service to internal and external stakeholders. 

Principal Activities May Include:  

• Research and resolve employer, agent and member inquiries and complaints. 

• Investigate and address employer payment discrepancies, fraud and abuse, and quality assurance complaints.  

• Interpret and communicate SoonerCare/Insure Oklahoma policies and procedures to employers, members, and stakeholders.  

• Educate on program coverage, services, and eligibility guidelines for SoonerCare, and Insure Oklahoma programs.  

• Process and resolve eligibility issues, payment discrepancies and invoice discrepancies. 

• Manage member applications, enrollments, plan changes, and eligibility verifications.  

• Identify and report system discrepancies.  

• Research and implement system updates and corrections.  

• Stay current on SoonerCare/Insure Oklahoma rule revisions and program changes.  

• Maintain organized reference materials and update written controls.  

• Coordinate with other departments on operational procedures.  

• Communicate independently with members, employers and stakeholders to resolve issues.  

• Participate in special projects, member and employer outreach, and educational efforts.  

• Represents OHCA in meetings, seminars, and training forums.  

• Support workflow during staff absences and manage high call volumes.  

• Other duties as assigned.  

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.  

Knowledge, Skills, Abilities and Competency Requirements 

IO Program Coordinator II requires in-depth knowledge of Medicaid program policies, strong communication skills for resolving inquiries, and the ability to manage complex administrative processes. This role demands attention to detail, effective collaboration, and the ability to navigate both member and employer concerns. The Korn Ferry competencies that align well with this position are Manages Complexity, for handling detailed program and policy administration, and Collaborates, for working effectively with both internal and external stakeholders to resolve issues and ensure program success. 

**To be considered for this position your application must include a resume/CV with complete work and education history.**

Education and/or Experience:  

• 1 year of experience as customer service representative. 

• An equivalent combination of education and experience, substituting thirty semester hours of college, including six semester hours in business or public administration for the required experience plus 1 years of experience in customer service, processing tax returns, bookkeeping or closely related work. 

Preference Qualifications Include:  

• Certifications in any of the following areas: Certified Medicaid Professional (CMP), Customer Service or Call Center Management Certification, Project Management Certification (PMP), Lean Six Sigma Certification, Certified Health Data Analyst (CHDA), or Health Insurance Portability and Accountability Act (HIPAA) Certification 

Physical Demands and Work Environment 

Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.