Medicaid Medical Director (Physician Administrator 3)

Job Overview 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 health care delivery for Ohio’s Medicaid population. Responsibilities 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, and 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. #J-18808-Ljbffr Ohio Department of Medicaid