Medicaid Clinical Programs Director — Quality & Access

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

Job summary

Alliant Health Solutions seeks a Director of Medicaid Clinical Programs to lead clinical and operational leadership across Medicaid contracts. You will oversee prior authorization, utilization review, quality improvement, and program integrity while partnering with analytics and operations to implement scalable, compliant workflows.

The role requires expertise in Medicaid delivery models and the ability to translate data into practical interventions for executives and state agencies.

Qualifications

• Experience leading Medicaid clinical and operational programs.
• Strong data analysis and dashboarding capabilities.
• Familiarity with regulatory and accreditation standards.
• Ability to communicate with executive audiences.
• Willingness to travel as needed.

Responsibilities

• Lead analysis of clinical and operational data across Medicaid programs.
• Oversee prior authorization and clinical operations.
• Partner with analytics to translate data into interventions.
• Develop reports for executives and state agencies.
• Drive process improvements and program integrity.

Skills

Team leadership

Prior authorization workflows

Regulatory compliance

Data analysis

Communication skills

Education

Bachelor's degree in nursing or public health or health administration

7–10 years healthcare experience

Medicaid programs knowledge

Job description

Alliant Health Solutions seeks a Director of Medicaid Clinical Programs to lead clinical and operational leadership across Medicaid contracts. You will oversee prior authorization, utilization review, quality improvement, and program integrity while partnering with analytics and operations to implement scalable, compliant workflows.

The role requires expertise in Medicaid delivery models and the ability to translate data into practical interventions for executives and state agencies.