Remote Medical Director — Quality & Utilization Leader

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

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Job summary

Centene is seeking a Medical Director-level leader to direct medical management, quality improvement and credentialing for the business unit. You will provide medical leadership for utilization management, cost containment and clinical quality improvement, guiding reviews and decision making.

Collaborate with care management teams, provider networks, and committees; support performance improvement initiatives; participate in policy development; may work weekends/holidays as needed to ensure

Qualifications

• MD/DO with Utilization Management experience.
• Experience with quality accreditation standards.
• Experience treating a culturally diverse population preferred.

Responsibilities

• Lead medical management and quality improvement activities for the business unit.
• Provide medical leadership for utilization review and credentialing.
• Collaborate with care management teams, network providers, and committees to ensure quality and cost-effectiveness.

Skills

Utilization Management

Quality Improvement

Medical Leadership

Clinical Reviews

Education

MD or DO

Board Certification (preferred)

Medical License (MD/DO)

Job description

Centene is seeking a Medical Director-level leader to direct medical management, quality improvement and credentialing for the business unit. You will provide medical leadership for utilization management, cost containment and clinical quality improvement, guiding reviews and decision making.

Collaborate with care management teams, provider networks, and committees; support performance improvement initiatives; participate in policy development; may work weekends/holidays as needed to ensure