Remote Medical Director: Quality & Utilization Leader

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

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements with remote

Job summary

Centene Management Company LLC seeks a Medical Director to lead utilization management, quality improvement, and credentialing across the business unit. You will review complex cases, coordinate with care management teams, and support performance improvement initiatives to enhance quality and cost-effectiveness of care.

The role requires an MD or DO with board certification and active state licensure, plus utilization management experience and leadership in a regulatory environment.

Qualifications

• Medical Doctor or Doctor of Osteopathy with active license.
• Utilization management experience and knowledge of accreditation standards.
• Experience treating a culturally diverse population preferred.
• Active board/certification in a relevant specialty (ABMS or AOA).

Responsibilities

• Direct and coordinate medical management, quality improvement and credentialing.
• Lead utilization review, quality assurance, and complex medical review activities.
• Support performance improvement initiatives for capitated providers.
• Participate in physician committees and develop education on clinical issues.

Skills

Utilization Management

Quality improvement

Medical leadership

Collaboration with clinical teams

Regulatory/accreditation knowledge

Education

MD or DO

Board certification in a medical specialty

Active certification in Internal or Family Medicine

Current state medical license

Job description

Centene Management Company LLC seeks a Medical Director to lead utilization management, quality improvement, and credentialing across the business unit. You will review complex cases, coordinate with care management teams, and support performance improvement initiatives to enhance quality and cost-effectiveness of care.

The role requires an MD or DO with board certification and active state licensure, plus utilization management experience and leadership in a regulatory environment.