Remote Behavioral Health Medical Director - UM & Quality

Centene Management Company LLC; Missouri; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules (remote,Hybrid

Job summary

Centene Management Company LLC is seeking a remote BH Medical Director to lead medical management, quality improvement, and credentialing for Utilization Management. You will support the CMO, analyze data, and drive strategic process improvements in a payer/managed care environment.

Board-certified in Psychiatry with an active MD or DO license is required, and UM experience with accreditation knowledge is preferred. Some weekend coverage may be required to support operations.

Qualifications

• Board certification in Psychiatry with ABPN certification required.
• Current MD or DO license without restrictions.
• Utilization Management experience and knowledge of accreditation standards preferred.
• Experience in payer/managed care environment is heavily preferred.

Responsibilities

• Provide medical leadership for utilization management, cost containment, and quality improvement.
• Direct and coordinate UM, quality improvement, and credentialing activities for the unit.
• Evaluate completed work, analyze data, and drive strategic process improvements.
• Collaborate with clinical teams, network providers, and committees; participate in provider network development.
• Perform medical reviews and assess medical necessity and payment in complex cases; support performance improvement initiatives.

Skills

Payer/Managed Care experience

Data analysis

Strategic planning

Medical leadership

Education

Medical Doctor or Doctor of Osteopathy

Course work in Health Administration / Health Financing

Job description

Centene Management Company LLC is seeking a remote BH Medical Director to lead medical management, quality improvement, and credentialing for Utilization Management. You will support the CMO, analyze data, and drive strategic process improvements in a payer/managed care environment.

Board-certified in Psychiatry with an active MD or DO license is required, and UM experience with accreditation knowledge is preferred. Some weekend coverage may be required to support operations.