Remote Medical Director: Utilization & Quality Leader

Centene Corporation; WaKeeney (KS); Hybrid; USD 237,000 - 449,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible work schedules

Job summary

Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options.

The candidate will collaborate with care management teams, providers, and committees, supporting regulatory compliance and accreditation standards while shaping physician education and network development.

Qualifications

• MD/DO degree required.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Active medical practice.
• Course work in Health Administration, Health Financing, Insurance, and/or Personnel Management advantageous.
• Experience caring for a culturally diverse population preferred.

Responsibilities

• Provide medical leadership for utilization management, cost containment, and medical quality improvement.
• Perform medical review activities related to utilization review and quality assurance.
• Support performance improvement initiatives for capitated providers.
• Assist Chief Medical Director with planning goals and policies for quality and cost-effectiveness.

Skills

Utilization management

Quality improvement

Medical leadership

Cross-functional collaboration

Education

MD/DO

Health administration/course work

Job description

Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options.

The candidate will collaborate with care management teams, providers, and committees, supporting regulatory compliance and accreditation standards while shaping physician education and network development.