Medical Director

Job Posting Title

Medical Director

Agency

807 HEALTH CARE AUTHORITY

Supervisory Organization

Medical Services

Job Posting End Date (Continuous if Blank)

June 24, 2025

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Full time

Job Type

Regular

Compensation

Based on education and experience.

Job Description

Agency/Division Information

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency's core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office.

Position Purpose

The Medical Director, a licensed medical doctor (MD), doctor of osteopathy (DO), is responsible for providing strategic leadership and medical expertise across the Oklahoma Health Care Authority (OHCA) to ensure the delivery of high-quality, evidence-based healthcare services. This role involves overseeing the evaluation of medical necessity, guiding the development of medical policies, and offering consultative medical input to various OHCA units. The Medical Director supports program integrity, quality assurance initiatives, and helps align medical operations with OHCA's mission to enhance access to better health outcomes for Oklahomans. Additionally, this role requires close collaboration with internal and external stakeholders to drive performance excellence, foster innovation in healthcare, and maintain alignment with the agency's values of accountability, transparency, and servant leadership. This position is ideal for an experienced physician, specifically a medical doctor (MD) or doctor of osteopathy (DO), who is committed to improving healthcare systems through thoughtful leadership and clinical insight. It calls for a mission-driven physician who brings a blend of clinical experience and systems-level thinking.

Principle Activities May Include:

• Serve as a medical consultant to units within OHCA to provide input regarding medical services.

• Make determinations of medical necessity by reviewing clinical records and direct contact with providers as necessary. Participate in the peer-to-peer email line by communicating with providers, providing information, guidance, and possible solutions as appropriate.

• Provide medical advice and review to the Program Integrity (PI) unit in identifying providers with potential inappropriate utilization and conducting PI audits.

• Identify medical technologies and assist the MASS unit in research medicine technologies that require a new or updated guideline based on evidence and the current standard of care.

• Become familiar with and develop relationships with the appropriate staff in other divisions to fulfill the responsibilities of the medical director.

• Summarize documentation and records for discussion internally and to present as needed at beneficiary appeals before the ALJ and other venues as directed.

• Provide guidance and support to the Director of Quality Assurance regarding the quality of care delivered, determining quality of care and medical home standards, and assist with claims review guidelines. Coordinate QI activities the EQRO with SoonerSelect CMO's and Quality Directors.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Knowledge, Skills, Abilities and Competencies

The Medical Director role requires in-depth knowledge of healthcare policies, state and federal legislation, and clinical standards, along with strong skills in program administration and medical evaluation to ensure compliance and effectiveness. This position demands exceptional communication abilities to collaborate across divisions and provide expert medical advice, along with strategic thinking to align medical operations with the broader organizational goals. The most fitting Korn Ferry competencies are Global Perspective, due to the need for understanding healthcare trends and policies, and Decision Quality, as the role involves making informed, high-impact decisions on medical necessity and program effectiveness.

To be considered for this position your application must include a resume/CV with complete work and education history.

Education and/or Experience:

• A current license to practice medicine as a medical doctor (MD) or doctor of osteopathy (DO) in the state of Oklahoma

• 3 years of clinical practice experience as a licensed physician.

Preference may be given to candidates with:

• Certifications in any of the following areas: Board Certification, Certified Physician Executive, Certification in Healthcare Quality, Medical Review Officer (MRO) Certification, Lean Six Sigma or similar process improvement certification

Physical Demands:

• Must be able to remain sitting for prolonged periods at a desk and working on a computer.

• Must be able to move or lift up to 15 pounds at various times.

Work Environment

The office work environment includes regular exposure to general office equipment such as computer equipment, phones, and copy machines.

Why You'll Love Working Here

At the Oklahoma Health Care Authority (OHCA), we're proud to create a workplace where employees thrive. Named a Top Workplace in Oklahoma for five consecutive years, this achievement reflects the dedication and collaborative spirit of our incredible team. Here's what we offer to support employees and their family:

• Generous state-paid benefit allowance to offset insurance premiums.

• A wide selection of top-tier health insurance plans.

• Optional flexible spending accounts for health care or dependent care expenses.

• Employee Assistance Program (EAP) offering confidential support.

• Wellness benefits, including an on-site gym and fitness center discounts.

• 11 paid holidays annually.

• 15 vacation days and 15 sick days in your first year.

• Retirement Savings Plan with substantial employer contributions.

• Longevity Bonus to reward years of service.

• Public Service Loan Forgiveness eligibility and reimbursement for educational expenses.

• Professional development training opportunities, including CEU support.

Accommodation Statement:

The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.

Notice to applicants:

Please add OHCAHR@okhca.org to the address book or "safe-senders" list in your email. All correspondence will come from this address. Be sure to check your junk folder. If you have questions about the status of your application, you can contact the HR team at 405-522-7093.

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub.

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.

Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.