Behavioral Medical Director - West Region

January 29

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

🎰 Nevada – Remote

Although this job is listed in Nevada, this company may be open to hiring remote in other states.

+2 more states

🏄 California – Remote 🎰 Nevada – Remote 🌲 Oregon – Remote ☕ Washington – Remote

💵 $231.9k - $440.5k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Centene Corporation

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Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

Contracting • Network Development • Managed Care

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

📋 Description

• 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 for utilization review and quality assurance • Collaborate with care management teams to optimize outcomes • Assist in provider network development and new market expansion • Develop and implement physician education on clinical issues and policies • Identify clinical quality improvement studies to reduce unwarranted variation in clinical practice • Review claims involving complex or controversial services for medical necessity and appropriate payment • Represent the business unit before various publics on medical philosophy and policies • May be required to work weekends and holidays as needed

🎯 Requirements

• 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 advantageous • Experience treating or managing care for a culturally diverse population preferred • Board certification by the American Board of Psychiatry and Neurology • Current state medical license without restrictions • Medical Licenses in CA, NV, OR, and/or WA preferred

🏖️ 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