Part-Time Medical Director, Utilization Management Indiana

Centene Corporation; Indiana; Hybrid; USD 142,000 - 271,000; Part time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/hybrid/office work

Job summary

Centene Corporation in Indiana seeks a Board Certified physician to lead utilization management for health plan units. The role directs medical review, case reviews, and quality improvement initiatives, with ~20 hours per week (Thursdays/Fridays priority).

Must hold Indiana license and be actively practicing, preferably Internal Medicine/Family practice, with UM experience. The successful candidate will collaborate with the CMO and MDs, providing medical leadership and ensuring cost-effective

Qualifications

• MD or DO with board certification (specialty preferred: internal medicine or family practice)
• Active Indiana medical license required
• Experience in utilization management and managed care preferred

Responsibilities

• Provide medical leadership for utilization management and medical review activities
• Perform case reviews and appeals for health plans
• Assist CMO in planning goals and policies to improve quality and cost-effectiveness
• Identify utilization trends and contribute to quality improvement studies
• Review claims involving complex or new services to determine medical necessity and payment

Skills

Medical leadership

Utilization management

Case reviews & appeals

Quality improvement

Regulatory compliance

Education

MD or DO, board certified

Indiana license active

Experience in managed care

Job description

Centene Corporation in Indiana seeks a Board Certified physician to lead utilization management for health plan units. The role directs medical review, case reviews, and quality improvement initiatives, with ~20 hours per week (Thursdays/Fridays priority).

Must hold Indiana license and be actively practicing, preferably Internal Medicine/Family practice, with UM experience. The successful candidate will collaborate with the CMO and MDs, providing medical leadership and ensuring cost-effective