Opening Date: May 21, 2020
Closing Date: June 19, 2020
Position Type: Contract
The Department of Health and Human Services (DHHS) provides supportive, preventive, protective, public health and intervention services that safeguard the public health and assist families and individuals to meet their needs. DHHS strives to provide these programs and services while respecting the rights and preferences of individuals and families. The Office of MaineCare Services (OMS) within DHHS administers the state’s Medicaid program and coordinates several major healthcare financing programs for Maine, including the Children’s Health Insurance Program (CHIP). OMS works collaboratively with the Commissioner’s Office of DHHS and the Office of the Governor on health reform and coordinates with other health plans and purchasers on statewide healthcare improvement initiatives. OMS ensures that the healthcare programs and services it administers operate in alignment with DHHS goals and federal mandates and are consistent with State policy. OMS also provides the oversight necessary to ensure accountability and efficient and effective administration and is responsible for the development of policies and programs that provide eligible Maine citizens with access to comprehensive, affordable, evidence-based healthcare.
The MaineCare Medical Director is responsible for providing clinical leadership and guidance to the MaineCare program and for supporting MaineCare goals and objectives established in coordination with the MaineCare Director and the Commissioner’s Office of DHHS. The Medical Director supports development and implementation of policy and programs that aim to improve health outcomes for Medicaid beneficiaries by improving population health outcomes and member experience and promoting high value care. The Medical Director directly communicates with healthcare providers in the state, participates in relevant advisory groups, and when needed, interacts with the state legislature at the direction of OMS leadership.
This position is intended to be full-time, but we may be willing to accept a 0.8 FTE position for the right candidate in order to, for example, facilitate continuation of clinical practice. This position is based in Augusta.
Key priorities for this position include:
- Ensuring that OMS policies are well-grounded in evidence and well-positioned to serve current Medicaid enrollees and an expanded Medicaid population
- Supporting the advancement of MaineCare’s focus on value-based care and alternative payment models
- Providing clinical leadership and oversight to ensure effective care coordination and management for high-need MaineCare members by MaineCare staff, external vendors and through healthcare delivery system initiatives
Typical responsibilities for this position include:
- Provide support to OMS leadership and staff to ensure implementation of MaineCare policy in accordance with federal and state regulations and in a manner that supports high quality care for MaineCare members
- Review and assist with the development and implementation of MaineCare policy and benefit design, including medical, pharmacy, and other benefit policies
- Assist with the development of quality standards and performance measures to assess provider performance
- Assist with the development of MaineCare strategic direction and programs to promote value-based purchasing
- Promote and disseminate clinically driven policy reforms that improve utilization management and transform the delivery system
- Provide leadership for and/or direct implementation of programs improving health or quality of care for beneficiaries (care coordination/case management)
- Support Maine’s Medicaid program through participation in national leadership and learning opportunities, including Medicaid Medical Director networks, national technical assistance opportunities, and presentations at local and national meetings, to inform and stay current on Medicaid best practices and foster state to-state learnings
- Participate on DHHS cross-office initiatives that require input from the MaineCare Medical Director
- Provide clinical guidance on DHHS projects and grant applications
To qualify, your background must include the following:
- Medical degree (MD or DO) from an accredited school of medicine; Master of Nursing from an accredited school of nursing; or Master of Science, Physician Assistant, from an accredited university
- Active state medical, nurse practitioner, or physician assistant license
- Relevant board certification
- Minimum of five (5) years of direct patient care experience, and relevant medical knowledge, with particular experience in adult primary care for Medicaid-eligible populations
Additionally, the following experience is preferred:
- Prior experience in medical leadership, in a management or supervisory role (e.g. practice or organizational Medical Director)
- Advanced training in health care management, public health, public policy, and/or business administration
- Prior experience in the analysis, interpretation, development, and implementation of policy or programs predominantly benefiting Medicaid populations at the state or federal level
- Knowledge of Medicaid policy, programs, and processes or similar knowledge in a Medicare or commercial health plan environment
- Ability to problem solve and make decisions to address complex clinical, compliance, policy, and operational issues
- Capacity to balance and negotiate between multiple, changing priorities
- Knowledge of delivery system redesign; quality improvement principles; utilization management principles; evidence-based decision making; patient-centered care principles; and disease management and care coordination principles
- Ability to be data driven, with a working knowledge of claims data systems, interpretation of statistical and outcome-based data analysis
- Experience with the development and implementation of clinical practice guidelines
- Experience leading teams through change
- Understanding of and commitment to public/population health principles
- Solid written and oral communication skills, including the ability to articulate issues in a concise manner that is understandable to a wide range of audiences
- Effective interpersonal influence, collaboration, and listening skills
- Management skills necessary to inspire, seek consensus, build teams, and manage conflict
- Leadership skills necessary to analyze and articulate complex policy concepts, envision change, and promote creative and innovative approaches and collaboration
For additional information about this position please contact Lisa Letourneau MD, MPH, DHHS Senior Advisor at (207) 415.4043 or by e-mail at email@example.com. To apply, please email a current resume and cover letter that addresses the qualifications and competency areas identified in the Requirements Section.
This is a contract position and does not qualify for benefits.
The Department of Health and Human Services is an Equal Opportunity/Affirmative Action employer. We provide reasonable accommodations to qualified individuals with disabilities upon request.