Senior Medical Director: Strategy & Utilization (Hybrid/Remote)

Centene Management Company LLC; New Hampshire; Hybrid; USD 215,000 - 409,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Holidays

Flexible work arrangements

Job summary

Centene Management Company LLC is seeking a Senior Medical Director to lead medical affairs, oversee denials/appeals, and provide executive clinical leadership for utilization management and quality initiatives. The role requires NH-based leadership or relocation, with collaboration across internal and external stakeholders.

The candidate will engage with state authorities, oversee physician committees, and ensure high-quality, cost-effective care for members in a dynamic, flexible work

Qualifications

• MD/DO with board certification in a medical specialty recognized by ABMS or AOA
• 7+ years of clinical experience; managed care or ACO leadership preferred
• Experience in utilization management, quality accreditation standards preferred
• Active clinical practice and ability to collaborate with cross‑functional teams

Responsibilities

• Direct and coordinate the medical affairs activities for the business unit
• Oversee the denials and appeals department and support clinical escalations
• Provide medical leadership for utilization management, pharmacy, case management, disease management, and quality improvement
• Represent the health plan with NH Department of Health and Human Services on clinical issues and advocacy

Skills

Clinical leadership

Utilization management

Education

Medical Doctor (MD) or Doctor of Osteopathy (DO)

Job description

Centene Management Company LLC is seeking a Senior Medical Director to lead medical affairs, oversee denials/appeals, and provide executive clinical leadership for utilization management and quality initiatives. The role requires NH-based leadership or relocation, with collaboration across internal and external stakeholders.

The candidate will engage with state authorities, oversee physician committees, and ensure high-quality, cost-effective care for members in a dynamic, flexible work