Medicaid Quality & Access Director

Alliant Health Group; Birmingham (AL); On-site; USD 120,000 - 190,000; Full time

Job summary

Alliant Health Solutions seeks a Director of Medicaid Clinical Programs to lead clinical and operational functions across Medicaid contracts. You will guide prior authorization, utilization review, and quality improvement while shaping strategies with analytics, technology, and operations teams.

Responsibilities include translating data into actionable priorities, overseeing contract-specific activities, and driving scalable, compliant processes to improve access, quality, and outcomes across

Qualifications

• Bachelor’s degree in nursing, public health, health administration, or related field.
• 7–10 years healthcare experience including authorization/ utilization review.
• Experience supporting multiple Medicaid programs or contracts.
• Proven ability to lead measurable process improvements using data.
• Strong knowledge of quality measurement and improvement methodologies.

Responsibilities

• Lead analysis of clinical, operational, claims, quality, and performance data across Medicaid programs.
• Provide strategic oversight for prior authorization and related clinical operations.
• Lead contract-specific clinical and operational activities including reviews and program integrity.
• Partner with analytics teams to translate data into priorities and dashboards.
• Lead process and quality improvement initiatives from assessment through monitoring.
• Develop reports and presentations for executives, customers, and state agencies.
• Collaborate with leaders to implement scalable, compliant processes and standards.
• Maintain current knowledge of Medicaid requirements and delivery models.
• Support new business opportunities with Program Directors and leaders.
• Perform other duties as assigned.

Skills

Team leadership

Prior authorization

Quality improvement

Data analysis

Communication

Presentations

Education

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

7–10 years healthcare experience

Experience with Medicaid programs/contracts

Master's degree preferred

National quality certification preferred

Tools

Microsoft Word

PowerPoint

Excel

Job description

Alliant Health Solutions seeks a Director of Medicaid Clinical Programs to lead clinical and operational functions across Medicaid contracts. You will guide prior authorization, utilization review, and quality improvement while shaping strategies with analytics, technology, and operations teams.

Responsibilities include translating data into actionable priorities, overseeing contract-specific activities, and driving scalable, compliant processes to improve access, quality, and outcomes across