Remote Behavioral Health Medical Director

Centene Corporation; Kentucky; Hybrid; USD 236,500 - 449,300; Full time

Benefits offered by this job

Health insurance

401(k) and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a clinical leader to assist the Chief Medical Director in directing medical management, credentialing, and quality improvement for the health services team. The role emphasizes utilization review, physician education, and collaboration with clinical teams to ensure high-quality, cost-effective care for members.

Qualified candidates hold an MD or DO with board certification (ABPN preferred) and active licensure.

Qualifications

• MD/DO with board certification preferred.
• Experience in utilization management and quality accreditation standards preferred.
• Active medical license without restrictions.
• Experience caring for diverse populations preferred.

Responsibilities

• Direct and coordinate medical management and credentialing for the business unit.
• Provide medical leadership for utilization management, cost containment, and quality improvement.
• Review medical necessity and complex or unusual services.
• Develop and implement physician education on clinical issues and policies.
• Collaborate with care management, network providers, and other teams.
• Support performance improvement initiatives for capitated providers.
• Participate in provider network development and market expansion.
• Advise on policy, committees, and regulatory compliance.

Skills

Utilization Management

Medical leadership

Quality improvement

Clinical collaboration

Education

MD/DO

Health administration background

Job description

Centene Corporation is seeking a clinical leader to assist the Chief Medical Director in directing medical management, credentialing, and quality improvement for the health services team. The role emphasizes utilization review, physician education, and collaboration with clinical teams to ensure high-quality, cost-effective care for members.

Qualified candidates hold an MD or DO with board certification (ABPN preferred) and active licensure.