Medicaid Medical Director (Physician Administrator 3)

State of Ohio • Columbus, OH

2d • Onsite

About The Position

The Ohio Department of Medicaid (ODM) is recruiting for a Physician Administrator with significant experience in clinical oversight to provide medical and clinical expertise and leadership to plan, coordinate, and direct all aspects of design, implementation, monitoring, and clinical evaluation of the ODM’s efforts to transform health care delivery of Medicaid covered services for Ohio’s Medicaid population. As the Medicaid Medical Director of Ohio’s largest healthcare provider, your duties will include: Defining ODM goals and objectives to improve health outcomes and overall healthcare quality in Ohio as detailed by the Ohio Medicaid Quality and Population Health Strategy and the associated metrics for Ohio's Medicaid population. Serving as clinical authority for ODM providing clinical oversight, input, and approval of coverage policies for all Medicaid services including pharmacy for eligible Ohioans in varied programs (Fee-For-Service, Managed Care, waivers). Providing leadership and oversight to utilization management, care coordination, and population health initiatives. Ensuring integration with other Department functions with alignment of policy, best clinical practice, and consumer needs using a person-centered approach, ensuring compliance with all state and federal regulations. Monitoring the delivery and cost-effectiveness of medical services and materials across varied provider types and care contexts and takes action to improve health system performance and patient experience. Supervising medical and non-medical ODM personnel to include Assistant Medicaid Medical Directors, Bureau Chiefs, supervisors and management personnel and/or medical support personnel.

Requirements

• Certificate to practice medicine as issued by State Medical Board pursuant to Sections 4731.14 & 4731.281 of Revised Code.
• Medical Technical Skills
• Medical Professional Skills
• Collaboration
• Goal Setting
• Innovation
• Leading Others
• Managing Meetings
• Organizing and Planning
• Performance Management
• Priority Setting
• Decision Making
• Delegation
• Strategic Thinking

Responsibilities

• Defining ODM goals and objectives to improve health outcomes and overall healthcare quality in Ohio as detailed by the Ohio Medicaid Quality and Population Health Strategy and the associated metrics for Ohio's Medicaid population
• Serving as clinical authority for ODM providing clinical oversight, input, and approval of coverage policies for all Medicaid services including pharmacy for eligible Ohioans in varied programs (Fee-For-Service, Managed Care, waivers)
• Providing leadership and oversight to utilization management, care coordination, and population health initiatives
• Ensuring integration with other Department functions with alignment of policy, best clinical practice, and consumer needs using a person-centered approach, ensuring compliance with all state and federal regulations
• Monitoring the delivery and cost-effectiveness of medical services and materials across varied provider types and care contexts and takes action to improve health system performance and patient experience
• Supervising medical and non-medical ODM personnel to include Assistant Medicaid Medical Directors, Bureau Chiefs, supervisors and management personnel and/or medical support personnel

Benefits

• 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 )

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Ph.D. or professional degree