National Medical Director: Quality & Utilization (Remote)

Centene Corporation; Enid (OK); 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

Descripción de la vacante

Centene Corporation seeks a physician leader to direct medical management, quality improvement, and credentialing for the unit. You will guide utilization review, ensure compliance with standards, and drive cost-effective, high-quality care for members.

Responsibilities include supporting performance-improvement initiatives, planning goals with the Chief Medical Director, and collaborating with clinical teams, networks, and committees. Board-certified MD/DO with active practice preferred.

Formación

• MD or DO with current license and active practice.
• Experience in Utilization Management and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in Health Administration, Health Financing, Insurance, or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

Responsabilidades

• Direct and coordinate medical management, quality improvement, and credentialing functions.
• Provide medical leadership for utilization management, cost containment, and quality improvement activities.
• Lead medical review activities for utilization review and quality assurance.
• Support performance improvement initiatives for capitated providers.
• Develop and implement physician education on clinical issues and policies.

Conocimientos

Utilization Management

Quality Improvement

Medical leadership

Regulatory compliance

Collaboration with clinical teams

Educación

MD or DO

Board certification in medical specialty

Descripción del empleo

Centene Corporation seeks a physician leader to direct medical management, quality improvement, and credentialing for the unit. You will guide utilization review, ensure compliance with standards, and drive cost-effective, high-quality care for members.

Responsibilities include supporting performance-improvement initiatives, planning goals with the Chief Medical Director, and collaborating with clinical teams, networks, and committees. Board-certified MD/DO with active practice preferred.