Medical Director - Behavioral Health Services

January 31

☕ Washington – Remote

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

💵 $210.8k - $400.5k / 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

• Provides clinical leadership and support to the Chief Medical Director • Directs and coordinates behavioral health medical management, quality improvement, and credentialing functions • Participates in performance and quality based on healthcare changes • Fosters Clinical Practice Guideline implementation and evidence-based medical practice • Interprets existing policies and develops new policies • Participates in regulatory, professional, and community activities • Ensures medical care meets acceptable standards • Develops and conducts reviews of claims and appeals • Leads and directs clinical and non-clinical development of Program implementation • Evaluates authorization requests timely and manages denial process • Complies with all policies and standards

🎯 Requirements

• Medical Doctor (MD) required • 10+ years of clinical experience required • 2+ years of Behavioral Health managed care experience required • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) required • Doctorate Degree in Medicine required • Board Certified in Psychiatry (ABPN) required • Washington state license as a MD without restrictions, limitations, or sanctions from government programs. • Additional board certification in child and adolescent psychiatry and/or Addiction Medicine highly 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.