Behavioral Medical Director

September 15

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• Assist the Chief Medical Director to direct and coordinate medical management • Provide medical leadership for utilization management, cost containment, and medical quality improvement • Perform medical review activities pertaining to utilization review and quality assurance • Conduct regular rounds to assess and coordinate care for high-risk patients • Collaborate with clinical teams and network providers for complex cases • Identify clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice • Review claims involving complex or new services to determine medical necessity.

Requirements

• Medical Doctor or Doctor of Osteopathy. • Utilization Management experience and knowledge of quality accreditation standards preferred. • Actively practices medicine. • Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. • Experience treating or managing care for a culturally diverse population preferred. • Board certification by the American Board of Psychiatry and Neurology. • Current Florida state medical license without restrictions.

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules