State Medicaid Medical Director

United States·Lincolnexecutive

OtherMedical Director

1 views0 saves0 applied

Apply Now

Quick Summary

Key Responsibilities

Serve as the senior physician leader for Nebraska Medicaid, providing strategic oversight of payer-side clinical and medical management functions, including medical policy, utilization management,

Technical Tools

OtherMedical Director

Health & Human Services - Agency 25

Lincoln, NE

$1.000

JR2026-00029293 State Medicaid Medical Director (Open)

The Nebraska Department of Health and Human Services (DHHS) is seeking an experienced physician leader to serve as Medical Director for the Division of Medicaid and Long-Term Care (MLTC). As Nebraska Medicaid's senior physician leader, the Medical Director provides strategic leadership and oversight of the clinical and medical management functions of a statewide Medicaid payer, supporting healthcare coverage and services delivered through managed care, fee-for-service, waiver, and other delivery models.

This role requires a physician leader who understands healthcare from both the clinical and payer perspective. The Medical Director provides oversight and direction across medical policy, utilization management, quality, pharmacy, credentialing, population health, and other clinical functions, balancing evidence-based care, member access, quality outcomes, regulatory requirements, and responsible stewardship of Medicaid resources.

The Medical Director serves as the principal physician advisor to MLTC leadership and works closely with Nebraska's Medicaid managed care organizations, providers, CMS, and other partners to evaluate healthcare utilization and outcomes, establish clinical policy and strategy, improve quality and access, and support the long-term sustainability of Nebraska's Medicaid program.

The position also provides physician leadership for Medicaid-related initiatives within Nebraska's Rural Health Transformation Program (RHTP), helping connect broader healthcare transformation efforts with Medicaid payment, quality, access, and delivery-system strategies.

As a member of the MLTC Executive Leadership Team, the Medical Director serves as a trusted advisor to agency leadership and helps shape clinical and healthcare policy affecting Nebraska Medicaid members statewide.

Responsibilities

~1 min read

→
Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) and an active, unrestricted Nebraska medical license or ability to obtain prior to employment.
→
Progressive physician leadership experience within a healthcare organization, health plan, or public healthcare system.
→
Experience with Medicaid, managed care, healthcare quality improvement, and healthcare policy.
→
Demonstrated ability to lead complex clinical initiatives and build collaborative partnerships with providers, executive leadership, legislators, and regulatory agencies.

Requirements

~1 min read

Physician leadership experience within a state Medicaid program, Medicaid managed care organization, health plan, or other government-sponsored healthcare program, or commercial health insurance.
Experience providing leadership or oversight of payer clinical functions such as utilization management, medical policy, quality, pharmacy, credentialing, population health, or value-based care.
Experience using claims, utilization, quality, cost, and population health data to inform clinical strategy, healthcare policy, and program performance.
Experience working with CMS, state Medicaid agencies, managed care organizations, or other government healthcare partners, including experience with healthcare payment or delivery-system transformation.
Experience and knowledge of care delivery in both an urban and highly rural healthcare setting

What We Offer

~1 min read

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.