Remote National Medical Director Quality Utilization

Centene Corporation; Kansas; Hybrid; USD 237,000 - 449,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules

Job summary

Centene Corporation seeks a senior physician leader to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role emphasizes utilization management, cost containment, and policy guidance to improve member outcomes.

The position collaborates with clinical teams, provider networks, and committees to drive performance improvement in capitated care, with occasional weekend/holiday duties as needed.

Qualifications

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

Responsibilities

• Direct and coordinate medical management, quality improvement and credentialing for the business unit.
• Provide medical leadership for utilization management, cost containment and quality improvement activities.
• Perform medical review activities to ensure timely, quality decisions.

Skills

Utilization management

Quality improvement

Medical review

Clinical leadership

Education

M.D./D.O.

Health admin coursework

Diversity care experience

Job description

Centene Corporation seeks a senior physician leader to assist the Chief Medical Director in directing medical management, quality improvement, and credentialing for the business unit. The role emphasizes utilization management, cost containment, and policy guidance to improve member outcomes.

The position collaborates with clinical teams, provider networks, and committees to drive performance improvement in capitated care, with occasional weekend/holiday duties as needed.