Remote Medical Director - Quality & Utilization Leadership

Centene Corporation; New Mexico; Hybrid; USD 237,000 - 449,000; Full time

Benefits offered by this job

Remote work options

Competitive benefits

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

Centene Corporation is seeking a clinically focused leader to drive utilization management, medical review, and quality improvement across a broad health services program. You will guide physicians, coordinate with care management teams, and help shape policies to improve care quality and cost-effectiveness for 28 million members.

The role requires MD/DO with active license, board certification, and extensive utilization management experience.

Qualifications

• MD or DO degree required.
• Active medical license in the United States.
• Board certification in a medical specialty recognized by ABMS or AOA preferred.

Responsibilities

• Provides medical leadership for utilization management, cost containment, and quality improvement.
• Performs medical reviews for utilization review and quality assurance.
• Assists in planning goals and policies to improve care quality and cost-effectiveness.
• Collaborates with clinical teams, network providers, and committees on complex cases.
• Represents the business unit on medical philosophy and policy issues.

Education

MD/DO

Board certification (ABMS/AOA)

Active medical license (MD/DO)

Tools

Utilization Management knowledge

Quality accreditation standards

Job description

Centene Corporation is seeking a clinically focused leader to drive utilization management, medical review, and quality improvement across a broad health services program. You will guide physicians, coordinate with care management teams, and help shape policies to improve care quality and cost-effectiveness for 28 million members.

The role requires MD/DO with active license, board certification, and extensive utilization management experience.