Behavioral Medical Director, Eastern Region (Hybrid/Remote)

Centene Management Company LLC; Missouri; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules (remote/hybrid

Job summary

Centene Management Company LLC in Missouri seeks a Medical Director to direct medical management, quality improvement, and credentialing for the business unit, providing leadership in utilization management and cost containment.

You will review complex medical cases, collaborate with care teams, and support performance improvement initiatives to meet regulatory and accreditation standards.

The role may involve representing the unit on committees and occasional weekend work.

Qualifications

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Active medical practice.
• Board certification by the American Board of Psychiatry and Neurology.
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

Responsibilities

• Direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.
• Provide medical leadership of utilization management, cost containment, and medical quality improvement activities.
• Perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex or controversial services.
• Support performance improvement initiatives and compliance with regulatory, state, corporate, and accreditation requirements.
• Represent the business unit before committees and engage with provider networks as needed.

Skills

Utilization Management

Quality Improvement

Medical Leadership

Education

Medical Doctor

Doctor of Osteopathy

Job description

Centene Management Company LLC in Missouri seeks a Medical Director to direct medical management, quality improvement, and credentialing for the business unit, providing leadership in utilization management and cost containment.

You will review complex medical cases, collaborate with care teams, and support performance improvement initiatives to meet regulatory and accreditation standards.

The role may involve representing the unit on committees and occasional weekend work.