Medicaid Medical Director 2025-01565 at State of Wyoming – Cheyenne, Wyoming

GENERAL DESCRIPTION:

The Wyoming Department of Health is seeking a mission-oriented Medical Doctor to serve as Medicaid Medical Director. As Medical Director, this leadership position will provide expertise in standards of care and quality of care to ensure Medicaid members can live healthy lives in Wyoming. This individual will work closely with internal Medicaid staff to lead healthcare quality and population health efforts for members of Wyoming Medicaid and CHIP. As Wyoming Medicaid’s clinical leader, this leadership role will engage with external healthcare providers, the community, organizations, and other government entities to promote access to high-quality, cost-effective services throughout the state. This individual will also serve as a clinical leader within the Public Health Division, specifically in the Ryan White/HIV Program and the Maternal and Child Health Unit. The Medicaid Medical Director will report directly to the Senior Administrator of the Division of Healthcare Financing and serve as a core member of the Division’s leadership team. This position offers a predictable schedule and will be located in Cheyenne with the opportunity to telework on a part-time basis.

Human Resource Contact: wdhrecruit@wyo.gov

ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function that may be performed in the job level.

• Develops and implements strategies to improve health outcomes for Wyoming Medicaid members.
• Develops and provides clinical oversight in the development of strategic goals, including quality improvement initiatives and high-value care models, objectives, guidelines, and policies.
• Analyzes population health data and utilizes evidence-based practices to provide recommendations on decision-making and policy development.
• Examines and evaluates programs within Wyoming Medicaid and Kid Care CHIP to determine the need for new programs or changes in existing programs; presents recommendations to the Senior Administrator; outlines proposed methods of meeting these needs.
• Coordinates program efforts with other agencies to assure agency compliance with federal and state regulations. Advises Department administrators of opportunities to improve intergovernmental collaboration.
• Represents the Department of Health at legislative hearings, contractor meetings, regional and national conferences, Advisory Council meetings, and actively participates in the Medicaid Medical Director Network.
• Actively outreaches to and directs communication with healthcare providers in the State, including physicians, hospitals, primary care clinics, skilled nursing facilities, specialists, etc.
• Collaborates across the Department of Health to assist with the most complex cases, investigations, research, and policy decisions. Ensures coordination of all clinical activities within the division.
• Participates in the Public Health Emergency Preparedness Program to ensure preparedness for, prevention of, response to, and recovery from public health emergencies through exercises, planning, education, and redundant communications.

• Leads state participants in the design and development of telehealth infrastructure and utilization across the state. Champions telehealth utilization across Wyoming. Develops processes for using telehealth resources to support and improve medical service delivery.
• For the Ryan White/HIV program and Maternal & Child Health programs, provides clinical oversight and decision-making perspective. Provides recommendations in program policy development, proposed legislation, strategic planning, and special projects.
• Attends various Medicaid advisory groups, professional meetings, and delivers technical assistance.
• Maintain knowledge of the latest trends and best practices in population health
• Present to varied audiences of clinical and non-clinical backgrounds on complex population health issues.

KNOWLEDGE:

• Demonstrated knowledge and expertise in healthcare quality and population health.

• Ability to analyze data and use evidence-based practices to inform decision-making.

• Knowledge of healthcare administration, including utilization management and health management best practices; the ability to comprehend federal regulations, state statutes, program rules, and policy. Ability to interpret and integrate the foregoing into legislation, statute, and policy.

• Excellent oral and written communication skills. Excellent interpersonal skills. Ability to communicate Medicaid program information and policy to public and private entities.

• Knowledge of emergency operations, preparedness, planning, and communications.

• Excellent leadership and management skills.

• Knowledge of telehealth practices and resources.

MINIMUM QUALIFICATIONS:


PHYSICAL WORKING CONDITIONS:

• Must be licensed or eligible for licensure by the State Board of Medical Examiners to practice medicine in the State of Wyoming.

• The employee may sit comfortably to perform the work; however, there may be some walking, standing, bending, carrying light items, driving an automobile, etc.

NOTES:

• FLSA: Exempt
• The Wyoming Department of Health is an E-Verify employer.
• The State of Wyoming offers an excellent benefits package.

048-Wyoming Department of Health - Division of Healthcare Financing - Administration

Click here to view the State of Wyoming Classification and Pay Structure.

URL: http://agency.governmentjobs.com/wyoming/default.cfm

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.