Assistant Medicaid Medical Director

Physician Pivot; Columbus (OH); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Medical Coverage

Dental & Vision

Paid Time Off

Holidays

Education Opportunities

Public Retirement

Job summary

The Ohio Department of Medicaid (ODM) is recruiting a Physician Administrator 2 for the position of Assistant Medicaid Medical Director. The role requires substantial clinical experience and reports to Health Innovation & Quality.

You will direct activities in utilization management or quality improvement, lead cross-functional teams, ensure compliance with provider agreements and state/federal requirements, and promote equity-focused care across Medicaid populations.

Qualifications

• Certificate to practice medicine in Ohio as issued by State Medical Board.
• Experience in healthcare administration preferred.
• Clinical experience required.

Responsibilities

• Directing activities in utilization management or quality improvement.
• Lead cross-functional teams with data-driven processes.
• Oversee provider agreement compliance with state and federal rules.
• Apply person-centered, equity-focused approaches to policies.
• Coach staff to drive improvements in health outcomes.

Skills

Medical

Doctor of Medicine

Education

Certificate to practice medicine in Ohio

Job description

All job postings will expire at 11:59 PM Eastern Time on the application deadline.

Organization: Medicaid

Agency Contact Name and Information: [e-mail]

Work Location: 50 West Town Street

Columbus, Ohio, 43215

United States

Compensation: Negotiable

Schedule: Permanent - Full Time

Work Hours: 8:00AM - 5:00PM

Classified Indicator: Unclassified

Union: Exempt from union

Primary Job Skill: Medical

THE WORK LOCATION OF THIS POSITION IS 50 WEST TOWN STREET, COLUMBUS, OHIO 43215. YOU WILL BE REQUIRED TO REPORT TO THIS WORK LOCATION, IF SELECTED.

Who We Are Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine's agenda for Ohio's future. To ensure Ohio is "the best place to live, work, raise and family and start a business," we must have strong schools, a great quality of life, and compassion for those who need our help.

Responsibilities

Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:

• Delivering a personalized care experience to more than three million people served.
• Improving care for children and adults with complex behavioral health needs.
• Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.
• Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.
• Ensuring financial transparency and operational accountability across all Medicaid programs and services.

What You’ll Do

Office: Health Innovation & Quality

Bureau: Health Innovation & Quality

Classification: Physician Administrator 2 (PN20100458)

Job Overview

The Ohio Department of Medicaid (ODM) is recruiting for a Physician Administrator with significant clinical experience. As the Assistant Medicaid Medical Director, your duties will include:

• Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department’s population health strategies, health equity, and other goals aimed at improving the quality of, and access to, services delivered to the Medicaid population
• Directing other agency/department staff/teams to implement utilization management and quality improvement policies, operations, and/or programs
• Providing leadership for cross-functional teams with clear communication, interpretation of shared data and structured processes to ensure consistency across different Medicaid populations and programs
• Developing and overseeing processes to ensure oversight of managed care organizations’ adherence to provider agreement requirements, and state and federal regulatory requirements
• Ensuring policies and operations reflect industry standards for utilization management that can be applied to individual circumstances, using a person-centered, equity-focused approach
• Providing consultation on the application of structured quality improvement tools (e.g. Key Driver Diagrams and simplified Failure Effectiveness Mode Analyses to drive insights and improvements in health outcomes for varied Medicaid populations using a person-centered and equity focused approach
• Providing expertise of effective organizational and leadership skills to coach internal and external personnel, ensuring team progress in meeting agency goals.

Additional Information

The Ohio Department of Medicaid does not provide employment-based visa sponsorship.

This position is overtime exempt.

This position is unclassified per 124.11 (A) (9), Ohio Revised Code.

The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full-time, if selected.

Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Benefits

Why Work For The State Of Ohio

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.

Qualifications

Certificate to practice medicine in state of Ohio as issued by State Medical Board pursuant to Section 4731.14 & 4731.281 of Revised Code.

Job Skills

Medical, Doctor of Medicine

ADA Statement

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.

Drug-Free Workplace

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.