Medicaid Medical Director (Physician Administrator 3)

50 W Town St (WTWN)
50 West Town Street
Suite 300
Columbus, 43215

THE WORK LOCATION OF THIS POSITION IS 50 WEST TOWN STREET, COLUMBUS, OHIO 43215. YOU WILL BE REQUIRED TO REPORT TO THIS WORK LOCATION, IF SELECTED.

About Us:

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help.

Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department 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.
• Ensuring financial transparency and operational accountability across all Medicaid programs and services.

THE WORK LOCATION OF THIS POSITION IS 50 WEST TOWN STREET, COLUMBUS, OHIO 43215. YOU WILL BE REQUIRED TO REPORT TO THIS WORK LOCATION, IF SELECTED.

About Us:

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help.

Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department 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.
• Ensuring financial transparency and operational accountability across all Medicaid programs and services.

What You Will Do At ODM:

Office: Health Innovation & Quality

Classification: Physician Administrator 3 (PN 20045297)

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 of Medicaid covered services for Ohio’s Medicaid population. As the Medicaid Medical Director of Ohio’s largest healthcare provider, your duties will 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 takes 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

What You Will Do At ODM:

Office: Health Innovation & Quality

Classification: Physician Administrator 3 (PN 20045297)

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 of Medicaid covered services for Ohio’s Medicaid population. As the Medicaid Medical Director of Ohio’s largest healthcare provider, your duties will 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 takes 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

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• Medical Cove