Pediatric 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 and quality improvement • Provides medical leadership for utilization management, cost containment, and medical quality improvement activities • Performs medical review activities pertaining to utilization review and quality assurance • Supports effective implementation of performance improvement initiatives • Assists in planning and establishing goals to improve care and service • Provides medical expertise in approved quality improvement programs • Conduct regular rounds to assess and coordinate care for high-risk patients • Collaborates with clinical teams, network providers, and medical consultants • Participates in provider network development and market expansion • Assists in physician education concerning clinical issues and policies • Identifies utilization review studies and evaluates adverse trends • Facilitates implementation of recommendations to improve medical care quality. • Represents the business unit on medical philosophy, policies, and related issues.

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 is advantageous • Experience treating or managing care for a culturally diverse population preferred • Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services • Current Florida state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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 • Total compensation may also include additional forms of incentives.