Remote Medical Director - Utilization & Cost Optimization

Centene Corp.; EE. UU.; A distancia; USD 215.000 - 409.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Descripción de la vacante

Centene Corp. seeks a Medical Director to lead medical management for Utilization Management and cost containment. This remote role focuses on strategic planning, data analysis, and optimization of UM processes while supporting the CMO and nursing leadership.

The ideal candidate holds an MD/DO with unrestricted license, has payer/manag ed care experience, and can drive quality improvements across networks and committees. Board certification and ongoing clinical practice are valued.

Formación

• Utilization Management experience and knowledge of quality accreditation standards.
• Active medical practice with an unrestricted US state license.
• Course work or experience in health administration, financing, or personnel management is advantageous.

Responsabilidades

• Provide medical leadership for utilization management, cost containment, and quality improvement initiatives.
• Perform medical reviews for utilization, quality assurance, and complex services to ensure timely, high-quality decisions.
• Support implementation of performance improvements for capitated providers and coordinate with clinical teams.

Conocimientos

Utilization Management

Data analysis

Leadership

Strategic planning

Healthcare management

Educación

Medical Doctor or Doctor of Osteopathy

Descripción del empleo

Centene Corp. seeks a Medical Director to lead medical management for Utilization Management and cost containment. This remote role focuses on strategic planning, data analysis, and optimization of UM processes while supporting the CMO and nursing leadership.

The ideal candidate holds an MD/DO with unrestricted license, has payer/manag ed care experience, and can drive quality improvements across networks and committees. Board certification and ongoing clinical practice are valued.