Remote National Medical Director: Quality & Utilization

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

Benefits offered by this job

Health insurance

401K plan

Stock options

Job summary

Centene Corporation is seeking a Physician Leader to assist the Chief Medical Director in directing medical management, quality improvement and credentialing for the business unit. You will provide medical leadership for utilization management, cost containment, and clinical quality initiatives.

Ideal candidates actively practice medicine, hold MD/DO credentials, and have board certification. The role may require weekend/holiday support and collaboration with networks and committees to improve

Qualifications

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• 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

• Assist the Chief Medical Director to direct and coordinate medical management, quality improvement and credentialing functions.
• Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
• Perform medical review activities pertaining to utilization review and quality assurance.
• Support performance improvement initiatives for capitated providers.
• Assist in planning and establishing goals and policies to improve quality and cost-effectiveness of care.

Skills

Utilization management

Quality improvement

Medical leadership

Regulatory knowledge

Cross-functional collaboration

Clinical governance

Education

MD/DO

Job description

Centene Corporation is seeking a Physician Leader to assist the Chief Medical Director in directing medical management, quality improvement and credentialing for the business unit. You will provide medical leadership for utilization management, cost containment, and clinical quality initiatives.

Ideal candidates actively practice medicine, hold MD/DO credentials, and have board certification. The role may require weekend/holiday support and collaboration with networks and committees to improve