Professional Provider Reimbursement Policy Manager (Technical Medical Specialist) - PN: 20068616
Columbus
Monday, 01 June 2026
William Green Building (WGBL)30 West Spring Street. Columbus, 43215-2256 A Little About Us:With roughly 1,500 employees in seven 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 strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums 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. BWC’s core hours of operation are Monday-Friday from 8:00 am to 5:00 pm, 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 7:00 am or as late as 8:30 am. Flex-time schedules are based on operational need and require supervisor approval. 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. If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application! What You’ll Be Doing:Lead the development and maintenance of the Professional Provider and Medical Services (PPMS) and other assigned fee schedules (IPPS, OPPS, ASC) aligning with relevant National (i.e., Medicare) and private payer’s methodologies. Design and implement medical and reimbursement policies to ensure accurate, efficient, and effective PPMS reimbursement systems. Analyze operations and systems to identify improvements and assess the impact of reimbursement methodologies on administrative functions. Deliver training sessions for Managed Care Organizations (MC - Os) and providers to support accurate billing and administration. Serve as the lead expert responding to inquiries and reimbursement approval requests related to PPMS methodologies or other assigned fee schedule.