Remote Medical Director – Utilization & Quality Improvement

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

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work options

Job summary

Centene Management Company LLC is seeking a remote Medical Director to lead Utilization Management, quality improvement, and credentialing within the medical management program. The role supports the CMO and collaborates with nursing leaders to optimize UM processes, review complex cases, and implement performance improvement initiatives.

Candidates must hold an MD or DO license with no restrictions, have UM or payer/managed care experience, and be prepared to engage with provider networks,

Qualifications

• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Board certification in a medical specialty recognized by the ABS or AOA is required.
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

Responsibilities

• Direct and coordinate medical management, quality improvement and credentialing functions for the business unit.
• Provide medical leadership of utilization management, cost containment, and medical quality improvement activities.

Education

Medical Doctor or Doctor of Osteopathy

Job description

Centene Management Company LLC is seeking a remote Medical Director to lead Utilization Management, quality improvement, and credentialing within the medical management program. The role supports the CMO and collaborates with nursing leaders to optimize UM processes, review complex cases, and implement performance improvement initiatives.

Candidates must hold an MD or DO license with no restrictions, have UM or payer/managed care experience, and be prepared to engage with provider networks,