Remote Medical Director: Quality & Utilization Leader

Centene Corporation; Louisiana; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off & holidays

Flexible work schedules (remote/hybrid

Job summary

Centene Corporation is seeking a physician leader to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role involves medical leadership for utilization management, cost containment, and quality initiatives across complex services.

The position requires active medical practice, board certification, and a state license. Collaboration with clinical teams and provider networks will be essential for improving outcomes

Qualifications

• MD or DO, board-eligible or -certified.
• long-form licensure in good standing is required.
• Experience with utilization management and quality standards desired.

Responsibilities

• Provide medical leadership for utilization management, cost containment, and quality improvement activities.
• Perform medical reviews for utilization and quality assurance to ensure timely, high-quality decisions.
• Support performance improvement initiatives for capitated providers and coordinate with care teams.
• Assist in planning goals and policies to improve quality and cost-effectiveness of care for members.
• Work with physician committees, review complex cases, and participate in provider network development.

Skills

Utilization management

Quality improvement

Medical leadership

Regulatory compliance

Clinical collaboration

Education

MD or DO

Board certification

State medical license

Job description

Centene Corporation is seeking a physician leader to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role involves medical leadership for utilization management, cost containment, and quality initiatives across complex services.

The position requires active medical practice, board certification, and a state license. Collaboration with clinical teams and provider networks will be essential for improving outcomes