Remote Behavioral Health Medical Director

Centene Corp.; Missouri; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plan

Tuition reimbursement

Paid time off + holidays

Flexible remote/hybrid options

Job summary

Centene Corp. is seeking a fully remote Behavioral Health Medical Director to guide medical management, quality improvement, and credentialing across markets.

The ideal candidate is agile, team-oriented, and experienced in teaching others, with board-certified Psychiatry and an active MD/DO license. The role focuses on case review, education, and process improvement, collaborating with care management and network providers.

Qualifications

• Board-certified Psychiatry physician with active state license.
• Utilization management and quality accreditation knowledge.
• Active medical practice in psychiatry and culturally diverse care.

Responsibilities

• Provides medical leadership of utilization management, cost containment, and quality improvement.
• Performs medical reviews for utilization and quality assurance with timely decisions.
• Supports performance improvement initiatives for capitated providers.
• Assists in planning goals and policies to improve cost-effectiveness of care.
• Offers medical expertise for quality improvement and utilization programs per requirements.
• Assists Chief Medical Director with physician committee structure and processes.
• Conducts rounds to assess care for high-risk patients with care teams.
• Collaborates with clinical teams, network providers, and consultants on reviews.
• Participates in provider network development and market expansion.
• Supports physician education on clinical issues and policies.
• Identifies utilization studies and evaluates trends in care utilization.
• Identifies clinical quality improvement studies to reduce variation.
• Interfaces with physicians to implement recommendations for improvement.
• Reviews complex claims to determine medical necessity and payment.
• Develops alliances with provider community through programs.
• Represents unit before publics and state committees as needed.
• May work weekends and holidays to support operations.

Skills

Medical leadership

Utilization management

Quality improvement

Teaching/education

Collaborative teamwork

Education

MD/DO

Board certification in Psychiatry

Job description

Centene Corp. is seeking a fully remote Behavioral Health Medical Director to guide medical management, quality improvement, and credentialing across markets.

The ideal candidate is agile, team-oriented, and experienced in teaching others, with board-certified Psychiatry and an active MD/DO license. The role focuses on case review, education, and process improvement, collaborating with care management and network providers.