Job Details

Medicaid Medical Director (Physician Specialist)

Oregon Health Authority, Salem OR

Job - Government

Close Date: 01/30/2020

A degree in either Medici nae Doctor (MD) or Doctor of Osteopathy (DO), and a current State of Oregon License by the time of hire are required.
The Oregon Health Authority (OHA) – Health Services Division (HSD) is currently seeking a Medicaid Medical Director (Physician Specialist) for the Health Systems Division (HSD) located in Salem, Oregon. This position serves as advisor to the OHA Chief Medical Officer, director and clinical manager of the Medicaid section by providing medical and clinical direction. This position serves as liaison with the medical community, other state agencies and medical organizations, and requires frequent local and in-state travel and occasional out-of-state travel.
What you will do!
As the Medicaid Medical Director, you will interpret and apply relevant laws and regulations and represent the Oregon Health Authority’s interpretation and application at public meetings and law hearings. This extends to the clinical appropriateness of administrative decisions, medical research and evaluation, medical input and support for Medicaid policy, provider services, managed health care, fee-for service, and programs operations sections.
Additionally, you will be responsible to provide consultation, decision making policy, and clinical direction in regard to individual case determinations, policy exceptions, provider appeals, pharmacy denials, administrative reviews, manual pricing, and claims re-determinations.
This is a part-time (.75 FTE) permanent position. It is an unclassified – excluded/non-supervisory position and is not represented by a union.
What we are looking for!
Special Requirements:
A degree in DO or MD and current State of Oregon license by the time of hire.
• Experience to interpret relevant laws and regulations and represent OHA’s interpretation and application of these at public meetings, including administrative law hearings;
• Experience to augment current medical information with new medial knowledge and to use sound clinical judgment in leading its application to the MAP;
• Experience in advancing health equity, addressing systemic health disparities and collaborating with diverse, vulnerable and underrepresented populations.
Preference given to those who have:
• MBA, MPH, MPA, or background in managed care, medical contracts or state policy initiatives;
• Background in medical utilization review or other administrative medical experience.

How to apply:
To be considered, you must complete an online application at the provided link.

Complete details: