Assistant Medicaid Medical Director – Quality & UM Leader

State of Ohio; Columbus (OH); On-site; USD 150,000 - 190,000; Full time

Job summary

The Ohio Department of Medicaid seeks a Physician Administrator 2 based in Columbus to lead clinical efforts in utilization management or quality improvement, aligning with population health and health equity goals.

You will direct cross-functional teams, ensure compliance with provider agreements and state/federal regulations, and coach staff to advance Medicaid outcomes within the Health Innovation & Quality bureau.

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.
• Physician Administrator responsibilities require clinical expertise and oversight.

Responsibilities

• Directing activities in a clinical focused area (Utilization Management or Quality Improvement) to align with population health strategies, health equity, and goals for improving quality and access.
• Directing other agency staff/teams to implement utilization management policies, operations, and programs.
• Providing leadership for cross-functional teams with clear communication and data-driven processes.
• Developing processes to oversee managed care organizations' adherence to provider requirements and regulatory requirements.
• Ensuring policies reflect industry standards for utilization management with a person-centered approach.
• Consulting on application of structured quality improvement tools to drive health outcomes across Medicaid populations.
• Coaching internal and external personnel to ensure progress toward agency goals.

Skills

Medical

Doctor of Medicine

Education

Certificate to practice medicine in state of Ohio

Job description

The Ohio Department of Medicaid seeks a Physician Administrator 2 based in Columbus to lead clinical efforts in utilization management or quality improvement, aligning with population health and health equity goals.

You will direct cross-functional teams, ensure compliance with provider agreements and state/federal regulations, and coach staff to advance Medicaid outcomes within the Health Innovation & Quality bureau.