Medicaid Medical Director: Strategy, Quality & Impact

Morgan Consulting Resources, Inc. - Healthcare Executive Search; Pittsburgh (Allegheny County); Sur place; USD 250 000 - 350 000; Plein temps

Résumé du poste

Senior Medical Director, Medicaid at UPMC for You reports to the CMO and leads medical strategy for a $5 billion Medicaid program with statewide reach in Pennsylvania.

The role combines clinical, operational, quality, and financial oversight to drive value-based care and performance Responsibilities include serving as the primary clinical liaison with DHS, ensuring regulatory compliance, developing quality programs, and partnering with Utilization Management, Care Management, Quality, and

Qualifications

• MD/DO required and Pennsylvania medical license.
• Board Certification in ABMS or equivalent.
• Post residency clinical experience required; 10+ years preferred.
• Clinical experience in historically underserved populations preferred.
• 10+ years of management experience preferred; experience in a managed care setting preferred.

Responsabilités

• Provide medical leadership for Medicaid product across clinical, operational, quality and financial performance.
• Ensure DHS contractual and regulatory obligations are met; liaise with DHS.
• Develop and execute strategies to improve quality and financial performance with value-based initiatives.
• Strengthen provider relationships and use data analytics to identify opportunities for improved outcomes.

Connaissances

MD/DO

PA license

Board Certification

Clinical leadership

Managed care experience

Formation

MD/DO degree

PA medical license

ABMS Board Certification

10+ years clinical experience

Description du poste

Senior Medical Director, Medicaid at UPMC for You reports to the CMO and leads medical strategy for a $5 billion Medicaid program with statewide reach in Pennsylvania.

The role combines clinical, operational, quality, and financial oversight to drive value-based care and performance Responsibilities include serving as the primary clinical liaison with DHS, ensuring regulatory compliance, developing quality programs, and partnering with Utilization Management, Care Management, Quality, and