Director, Medicaid Quality & Access

Alliant Health Group; Ridgeland (MS); On-site; USD 150,000 - 230,000; Full time

Job summary

Alliant Health Solutions is seeking a Director of Medicaid Clinical Programs to provide clinical and operational leadership across Medicaid contracts. You will oversee prior authorization, utilization review, quality improvement, compliance, and program integrity, translating data into actions and scalable workflows.

Collaborate with analytics, technology, and operations leaders to enhance access, quality, and outcomes for Medicaid populations, supporting state agencies and providers while

Qualifications

• Bachelor's degree in nursing, public health, health admin, or related field.
• 7–10 years of healthcare experience including prior authorization/utilization review.
• Experience supporting multiple Medicaid programs or contracts.
• Proven record of process improvements using clinical and operational data.
• Strong knowledge of healthcare quality measurement and improvement.

Responsibilities

• Lead analysis of clinical, operational, claims, quality data across Medicaid programs.
• Provide strategic oversight for prior authorization and related operations.
• Oversee contract-specific clinical activities and program integrity.
• Collaborate with analytics to translate data into actionable priorities.
• Develop reports and presentations for executives and state agencies.
• Implement scalable, compliant processes across teams.
• Stay current on Medicaid requirements and delivery models.
• Partner with leadership on new business opportunities.

Skills

Medicaid knowledge

Leadership

Data analysis

Regulatory compliance

Stakeholder management

Presentation

Education

Bachelor's degree in nursing

Tools

Word

PowerPoint

Excel

Job description

Alliant Health Solutions is seeking a Director of Medicaid Clinical Programs to provide clinical and operational leadership across Medicaid contracts. You will oversee prior authorization, utilization review, quality improvement, compliance, and program integrity, translating data into actions and scalable workflows.

Collaborate with analytics, technology, and operations leaders to enhance access, quality, and outcomes for Medicaid populations, supporting state agencies and providers while