Assistant Medicaid Medical Director (Physician Administrator 2)

Responsibilities

Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department’s population health strategies, health equity, and other goals aimed at improving the quality of, and access to, services delivered to the Medicaid population.

Directing other agency/department staff/teams to implement utilization management and quality improvement policies, operations, and/or programs.

Providing leadership for cross-functional teams with clear communication, interpretation of shared data and structured processes to ensure consistency across different Medicaid populations and programs.

Developing and overseeing processes to ensure oversight of managed care organizations’ adherence to provider agreement requirements, and state and federal regulatory requirements.

Ensuring policies and operations reflect industry standards for utilization management that can be applied to individual circumstances, using a person-centered, equity-focused approach.

Providing consultation on the application of structured quality improvement tools (e.g. Key Driver Diagrams and simplified Failure Effectiveness Mode Analyses to drive insights and improvements in health outcomes for varied Medicaid populations using a person-centered and equity focused approach).

Providing expertise of effective organizational and leadership skills to coach internal and external personnel, ensuring team progress in meeting agency goals.

Qualifications

Certificate to practice medicine in state of Ohio as issued by State Medical Board pursuant to Section 4731.14 & 4731.281 of Revised Code.

Technical Skills

• Health Administration
• Medical Professional Skills

Agency Contact

HumanResources@medicaid.ohio.gov

About Us

The Ohio Department of Medicaid (ODM) is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by delivering a personalized care experience to more than three million people served, improving care for children and adults with complex behavioral health needs, working collectively with our partners and providers to measurably strengthen wellness and health outcomes, streamlining administrative burdens so doctors and healthcare providers have more time for patient care, and ensuring financial transparency and operational accountability across all Medicaid programs and services.