Remote Medical Director - Quality & Utilization

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

Job summary

Centene Management Company LLC is seeking a Board-certified physician to assist the Chief Medical Officer in directing medical management, quality improvement, credentialing, and utilization review for the Georgia-based program. The role requires active medical practice, state licensure in Georgia, and leadership across clinical teams including committees and provider networks.

Weekend/holiday flexibility may be required.

Qualifications

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Experience treating or managing care for a culturally diverse population preferred.

Responsibilities

• Direct and coordinate medical management, quality improvement and credentialing functions for the business unit.
• Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
• Conduct medical reviews for utilization review, quality assurance, and complex/experimental services.
• Lead performance improvement initiatives and provider education.
• Represent the business unit on medical philosophy, policies, and committees.

Skills

Board certification

Leadership

Clinical expertise

Utilization management

Quality improvement

Education

MD/DO

Health admin coursework advantageous

Job description

Centene Management Company LLC is seeking a Board-certified physician to assist the Chief Medical Officer in directing medical management, quality improvement, credentialing, and utilization review for the Georgia-based program. The role requires active medical practice, state licensure in Georgia, and leadership across clinical teams including committees and provider networks.

Weekend/holiday flexibility may be required.