Remote Medical Director, Utilization & Quality Improvement

Centene Corporation; Tennessee; Híbrido; USD 215 000 - 409 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible/remote work options

Resumo da oferta

Centene Corporation is seeking a Medical Director to provide medical leadership for utilization management, cost containment, and quality improvement across member care. The role involves medical review activities, collaboration with care management teams, and participation in provider network development.

Ideal candidates hold an MD or DO and actively practice medicine, with experience in utilization management and knowledge of accreditation standards.

Qualificações

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

Responsabilidades

• Provide medical leadership for utilization management, cost containment, and quality improvement.
• Perform medical review for utilization review, quality assurance, and medical review of complex services.
• Collaborate with provider networks to review complex cases and appeals.
• Participate in provider network development and education initiatives.

Conhecimentos

Utilization management experience

Quality accreditation standards

Active medical practice

Formação académica

MD/DO

Health Administration coursework

Diversity of patient population experience

Descrição da oferta de emprego

Centene Corporation is seeking a Medical Director to provide medical leadership for utilization management, cost containment, and quality improvement across member care. The role involves medical review activities, collaboration with care management teams, and participation in provider network development.

Ideal candidates hold an MD or DO and actively practice medicine, with experience in utilization management and knowledge of accreditation standards.