Nebraska Department of Health & Human Services

Position: Medical Director, Division of Medicaid and Long-Term Care

Location: Lincoln, NE

Organization:

The Department of Health and Human Services (DHHS) team contributes to the lives and health of Nebraskans every day; its mission – "Helping people live better lives" – provides the motivation to make a difference. Some DHHS programs impact all Nebraskans, such as educating and protecting residents through public health activities like ensuring clean and safe drinking water and licensing and certifying all health care professionals; DHHS also touches the state's most vulnerable citizens with services that assist the elderly, low-income residents, the disabled, abused and neglected children, and vulnerable adults. DHHS is Nebraska's largest state agency and is responsible for nearly one-third of state government, in terms of teammates and budget. It is comprised of five divisions, seven facilities, and eight operational areas. The five division directors, who are appointed by the governor and confirmed by the legislature, report to the chief executive officer; these divisions are: Behavioral Health, Children and Family Services, Developmental Disabilities, Medicaid and Long-Term Care, and Public Health.

The Division of Medicaid and Long-Term Care (MLTC) is the largest division within DHHS, representing 71% of its overall budget and encompassing Medicaid and the Children's Health Insurance Program, Home and Community Services for Aging and Persons with Disabilities, and the State Unit on Aging. Medicaid funds for healthcare services are available to eligible elderly, persons with disabilities, low-income pregnant women, and children and their parents, covering more than one in every 10 Nebraskans. MLTC administers non-institutional home and community-based waivers for the aged, adults and children with disabilities, and infants and toddlers with special needs, and is responsible for Medicaid eligibility determination, policy, provider enrollment, rate setting and reimbursement activities, claims processing, and program integrity activities. Medicaid in Nebraska is delivered through managed care in the Heritage Health program. Nebraska Medicaid contracts with three managed care organizations (MCOs): Nebraska Total Care, United Healthcare Community Plan, and WellCare of Nebraska.

Community:

Lincoln is the capital of Nebraska and the county seat of Lancaster County; with a population of approximately 284,750, it is the second-most populous city in Nebraska. It is the economic and cultural anchor of a substantially larger metropolitan area in the southeastern part of the state called the Lincoln Metropolitan and Lincoln-Beatrice Combined Statistical Areas, home to approximately 353,120 residents. As the city is the seat of government for the state of Nebraska, the state and federal government are major employers; the University of Nebraska, founded in 1867, is the city's third-largest employer, with other primary employers falling within the service and manufacturing industries, including a growing high-tech sector – the region makes up part of what is known as the greater Midwest Silicon Prairie. Lincoln has been ranked fourth on Forbes' list of "Best Places for Business and Careers," first among NerdWallet's "Best Cities for Job Seekers," and second on SmartAsset's list of "Cities with the Best Work/Life Balance." The city has also been named among the top 10 best places to retire by U.S. News & World Report.


Job Description:

The Nebraska Division of Medicaid and Long-Term Care is seeking a motivated and energetic individual to serve as its senior clinical and quality leader. This division has an annual budget of over $2.5 billion and is responsible for the provision of health coverage to nearly 240,000 Nebraskans through Medicaid and the Children's Health Insurance Program. Reporting to the Governor appointed Director of Medicaid & Long-Term Care; the medical director will direct clinical staff, provide clinical decision-making for the program, and play a leading role in developing and leading the program's new population health and analytics strategy focused on the Quadruple Aim. He or she will be expected to work with the Medicaid managed care organizations (MCOs) and oversee the medical management of the division to improve the patient experience of care, the provider experience, the health of populations served, and to reduce the per capita cost of care.


Search Team:

Derek J. Castaneda

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