Remote Medical Director, Utilization & Quality Improvement

Centene Corporation; Maine; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Stock purchase plans

Tuition reimbursement

Paid time off + holidays

Job summary

Centene Corporation is seeking a physician leader to drive utilization management, clinical quality, and payment accuracy across our programs. The role requires active medical practice, board certification, and an ability to collaborate with clinical and network teams to improve outcomes and cost-effectiveness.

The position offers flexible work arrangements including remote, hybrid, field, or office options and requires commitment to patient-centered care and regulatory compliance.

Qualifications

• MD/DO with board certification and active medical license.
• Experience in utilization management and quality accreditation standards.
• Active medical practice in related specialty.

Responsibilities

• Provide medical leadership for utilization management, cost containment, and quality improvement.
• Perform medical reviews for utilization review and quality assurance to ensure timely decisions.
• Support performance improvement initiatives for capitated providers.
• Lead physician education on clinical issues and policies.
• Coordinate with care teams to optimize outcomes for high-risk patients.

Skills

Utilization Management

Quality improvement

Medical review

Clinical oversight

Education

MD/DO

Board certification in a medical specialty

Current state medical license

Job description

Centene Corporation is seeking a physician leader to drive utilization management, clinical quality, and payment accuracy across our programs. The role requires active medical practice, board certification, and an ability to collaborate with clinical and network teams to improve outcomes and cost-effectiveness.

The position offers flexible work arrangements including remote, hybrid, field, or office options and requires commitment to patient-centered care and regulatory compliance.