Job description

Shall be responsible for the medical administration of long-term care programs within the District’s Medicaid program, in collaboration with the agency’s Medical Director and the management of the Long Term Care Administration.

Responsibilities

1) Develops and maintains professional relationships with the provider community and professional organizations, including DC Medicaid Society; DC Health Care Association; DC Home Health Association; and others.

2) Collaborates with DHCF senior staff on peer review and quality improvement activities.

3) Conducts medical reviews and individual reconsiderations applicable to the authorization of long-term services and supports, in collaboration with the Medical Director.

4) Collaborates and advises the Medical Director, the Long Term Care Director and the Medicaid Director on policy development pertinent to long-term services and supports, including medical necessity criteria, patient health and welfare, assessments, clinical protocols, and other areas as appropriate.

5) Participates in the accomplishments of administrative and program responsibilities within the Long Term Care Administration and the agency as a whole.

6) Assists the Long Term Care Director, Medical Director, and others in the operations and oversight of long-term care programs and programs serving individuals enrolled in both Medicare and Medicaid.

7) Assists the Long Term Care Director, the Medical Director, and the Medicaid Director in the execution of Department programs consistent with the policy framework established by the Mayor and the City Council, including the Medicaid State Plan and applicable Medicaid waivers.

8) Provides community and professional organization collaboration and communications as the medical director for long-term care programs in the District’s Medicaid program.

9) Keeps informed about current health services programs in other areas, under other payors, and in other jurisdictions in order to inform the District’s programs and policies.

10) Serves as consultant and participant internally within DHCF for initiatives that require medical expertise, particularly as it pertains to long-term services and supports, programs serving special needs populations, and programs serving dual eligibles.

11) Represents the Department, the Medicaid Director, the Medical Director, or the Long Term Care Director at professional and public meetings as assigned. Provides consultative advice to community partners as appropriate or as assigned.

Qualifications

1) Physician’s license to practice Medicine and Surgery in the District of Columbia.

2) At least five years of supervisory or managerial experience in a public health agency or health organization.

3) Expert professional knowledge and experience with quality improvement, performance improvement and clinical guidelines.

4) Expert knowledge of public health policy, Medicaid program policy, and long-term services and supports.

5) Expert knowledge of federal, regional, state, and local governmental structure, services, and facilities, and of governmental rules, regulations, policies, and procedures.

6) Extensive experience in management and the ability to lead, mentor, manage, and provide technical direction to diverse, professional staff.

7) Expert knowledge of the requirements and practices to protect the security and confidentiality of private health information.

8) Strong analytical skills, the ability to evaluate and synthesize information, develop appropriate plans and to assess programs, activities, and services.

9) Excellent interpersonal and engagement skills in support of professional relationship development and maintenance.

Job Type: Full-time

Pay: $200,000.00 - $250,000.00 per year

Schedule:

• 8 hour shift

Ability to commute/relocate:

• Washington, DC 20001: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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