Remote Medical Director: Quality & Utilization

Centene Corporation; Iowa (LA); Hybrid; USD 237,000 - 449,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a clinical leader to oversee medical management, utilization review, and quality improvement for a large member population. You will drive medical review of complex cases, support performance initiatives, and collaborate with care teams to optimize costs and outcomes.

The role emphasizes leadership, regulatory compliance, and ongoing professional practice in a dynamic, flexible work environment across multiple markets.

Qualifications

• MD or DO with active practice.
• Utilization management experience preferred.
• Experience with quality accreditation standards.
• Course work in health administration/financing/insurance advantageous.
• Experience serving diverse populations preferred.

Responsibilities

• Provide medical leadership for utilization management, cost containment, and medical quality improvement.
• Perform medical reviews for utilization review and complex or experimental services.
• Support performance improvement initiatives for capitated providers.
• Assist in planning goals and policies to improve quality and cost-effectiveness.
• Represent medical philosophy and policies to publics and committees as needed.
• Coordinate with care management and provider networks to improve outcomes.

Skills

Medical leadership

Utilization management

Quality improvement

Care coordination

Education

MD or DO

Course work in Health Admin/Fin/Insurance/Management

Job description

Centene Corporation is seeking a clinical leader to oversee medical management, utilization review, and quality improvement for a large member population. You will drive medical review of complex cases, support performance initiatives, and collaborate with care teams to optimize costs and outcomes.

The role emphasizes leadership, regulatory compliance, and ongoing professional practice in a dynamic, flexible work environment across multiple markets.