National Medical Director: Quality & Utilization Leader

Centene Corporation; United States; Híbrido; USD 215.000 - 409.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Descripción de la vacante

Centene Corporation seeks a Medical Director to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role provides medical leadership across utilization management, cost containment, and patient care quality.

Responsibilities include medical reviews, performance improvements, plan implementation, and collaboration with providers and care teams to optimize outcomes. Requires MD/DO licensure and board certification.

Formación

• Active medical practice with MD/DO license.
• Experience in utilization management and quality accreditation standards.
• Experience with culturally diverse populations.

Responsabilidades

• Provide medical leadership for utilization management, quality improvement, and credentialing.
• Perform medical reviews for utilization, quality assurance, and medical necessity decisions.
• Support performance improvement initiatives for capitated providers.
• Plan and implement goals and policies to improve quality and cost-effectiveness of care for members.
• Represent the business unit on state committees and public forums as needed.
• Collaborate with clinical teams, providers, appeals team, and consultants on complex cases.

Conocimientos

Utilization management

Quality improvement

Medical leadership

Educación

Medical Doctor (MD) or Doctor of Osteopathy (DO)

Health administration / Health financing coursework

Descripción del empleo

Centene Corporation seeks a Medical Director to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role provides medical leadership across utilization management, cost containment, and patient care quality.

Responsibilities include medical reviews, performance improvements, plan implementation, and collaboration with providers and care teams to optimize outcomes. Requires MD/DO licensure and board certification.