Behavioral Medical Director - Eastern Region (Remote/Hybrid)

Centene Corporation; United States; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote/hybrid/field/office flexibility

Job summary

Centene Corporation seeks a physician leader to direct and coordinate medical management, quality improvement, and credentialing for the unit. You will lead utilization review, complex case reviews, and provider collaboration to ensure high-quality, cost-effective care.

The role requires MD/DO with active practice, board certification, and experience in utilization management and accreditation standards. Board certification in psychiatry is preferred; licensure must be unrestricted.

Qualifications

• MD or DO with valid state license to practice medicine.
• Board certification by the American Board of Psychiatry and Neurology.
• Child Psychiatry certification preferred.
• Utilization management experience and knowledge of quality accreditation standards.

Responsibilities

• Lead medical management, utilization review, and quality improvement activities.
• Review complex or novel medical services for medical necessity and payment.
• Support performance improvement initiatives for capitated providers.
• Assist in planning goals and policies to improve care quality and cost-effectiveness.
• Provide medical expertise for QA, UM, and accreditation programs.

Skills

Utilization Management

Quality accreditation

Active medical practice

Diversity/cultural experience

Education

MD or DO

Health Administration coursework

Health Financing coursework

Insurance coursework

Personnel Management coursework

Job description

Centene Corporation seeks a physician leader to direct and coordinate medical management, quality improvement, and credentialing for the unit. You will lead utilization review, complex case reviews, and provider collaboration to ensure high-quality, cost-effective care.

The role requires MD/DO with active practice, board certification, and experience in utilization management and accreditation standards. Board certification in psychiatry is preferred; licensure must be unrestricted.