Medical Director

2 days ago

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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, quality improvement, and credentialing functions • Provides medical leadership for utilization management, cost containment, and medical quality improvement activities • Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex services • Supports implementation of performance improvement initiatives for capitated providers • Assists in planning and establishing goals and policies to improve quality and cost-effectiveness of care • Conducts rounds to assess and coordinate care for high-risk patients • Collaborates with clinical teams and network providers for reviewing complex cases

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, 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 Michigan 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