Medicaid Medical Director (Physician Administrator 3)

State of Ohio; Columbus (OH); On-site; USD 120,000 - 160,000; Full time

Job summary

The State of Ohio is seeking a Physician Administrator for the Ohio Department of Medicaid to lead and manage clinical oversight of Medicaid services. This role involves defining health outcomes, providing leadership for patient care initiatives, and ensuring compliance with regulations for Ohio's Medicaid population.

The successful candidate must possess a medical license and demonstrate skills in collaboration, innovation, and strategic thinking. It offers the opportunity to contribute significantly to healthcare transformation and quality improvement across Ohio.

Responsibilities

• Define ODM goals and objectives to improve health outcomes.
• Serve as clinical authority providing oversight and input on policies.
• Provide leadership to utilization management and population health.
• Ensure integration with other Department functions.
• Monitor delivery and cost-effectiveness of medical services.
• Supervise medical and non-medical personnel.

Skills

Collaboration

Goal Setting

Innovation

Leading Others

Managing Meetings

Organizing and Planning

Performance Management

Priority Setting

Decision Making

Delegation

Strategic Thinking

Education

Certificate to practice medicine issued by State Medical Board

Job description

Organization

Ohio Department of Medicaid (ODM)

Work Location

50 W Town St, 50 West Town Street Suite 300, Columbus, OH 43215

Schedule

Full-time

Primary Job Skill

Medical

Job Description

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 healthcare delivery of Medicaid covered services for Ohio’s Medicaid population. As the Medicaid Medical Director, your duties 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 taking 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, management personnel, and/or medical support personnel.

Qualifications

Certificate to practice medicine as issued by State Medical Board pursuant to Sections 4731.14 & 4731.281 of Revised Code.

Professional skills: Collaboration, Goal Setting, Innovation, Leading Others, Managing Meetings, Organizing and Planning, Performance Management, Priority Setting, Decision Making, Delegation, Strategic Thinking.

Supplemental Information

This position is OT‑exempt. Travel required as needed; applicant must provide own transportation or possess a valid driver’s license for state vehicle use.

Resumes and/or attachments are not reviewed. Detail is required in the work experience section of the application.

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.