Remote Medical Director: Quality & Utilization Leader

Centene Corporation; WaKeeney (KS); 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 (remote,hyb

field or office)

Job summary

Centene Corporation is seeking a senior medical leader to oversee utilization management, medical review, and quality improvement programs. This role involves coordinating with care teams, providers, and committees to optimize patient outcomes.

Responsibilities include developing policies, supporting performance improvement initiatives, and ensuring regulatory compliance while maintaining patient-centered care and cost-efficiency across the network.

Qualifications

• MD or DO required; board-certified preferred.
• Active medical practice is required.
• Experience with utilization management and quality standards preferred.
• Course work in health administration, health financing, insurance or personnel management is advantageous.

Responsibilities

• Provide medical leadership for utilization management and cost containment.
• Oversee medical review activities for utilization review and quality assurance.
• Support performance improvement initiatives for capitated providers.
• Assist in planning goals and policies to improve care quality and cost-effectiveness.
• Represent the business unit in medical philosophy and policy discussions.

Skills

Utilization Management

Quality improvement

Medical leadership

Physician collaboration

Education

MD/DO degree

Board certification

Active medical practice

Health admin coursework

Job description

Centene Corporation is seeking a senior medical leader to oversee utilization management, medical review, and quality improvement programs. This role involves coordinating with care teams, providers, and committees to optimize patient outcomes.

Responsibilities include developing policies, supporting performance improvement initiatives, and ensuring regulatory compliance while maintaining patient-centered care and cost-efficiency across the network.