Remote Medicare Medical Director — Quality & Utilization

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

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

PTO + holidays

Flexible work arrangements

Job summary

Centene Corporation seeks a physician leader to direct medical management, quality assurance, and credentialing for the business unit. This role provides medical leadership across utilization management, cost containment, and quality improvement initiatives.

Responsibilities include supporting performance improvement, planning goals, and applying regulatory standards while collaborating with care teams to optimize patient outcomes.

Qualifications

• Active MD/DO license in good standing.
• Board-certified in a medical specialty recognized by ABMS/AOA.
• Utilization management experience preferred.
• Active medical practice with clinical duties.

Responsibilities

• Direct medical management, quality improvement and credentialing for the business unit.
• Lead utilization review and quality assurance activities ensuring timely decisions.
• Support performance improvement initiatives for capitated providers.
• Develop goals and policies to improve quality and cost-effectiveness of care.
• Provide medical expertise for accreditation and regulatory requirements.
• Coordinate with physician committees and governance structures.

Skills

Medical leadership

Utilization management

Quality improvement

Care coordination

Clinical decision making

Education

MD/DO licensed

Board certification (medical specialty)

Internal/Family Medicine certification

Job description

Centene Corporation seeks a physician leader to direct medical management, quality assurance, and credentialing for the business unit. This role provides medical leadership across utilization management, cost containment, and quality improvement initiatives.

Responsibilities include supporting performance improvement, planning goals, and applying regulatory standards while collaborating with care teams to optimize patient outcomes.