Medical Director - Remote

September 25

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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, controversial, or experimental medical services • Supports effective implementation of performance improvement initiatives for capitated providers • Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care for members • Provides medical expertise in the operation of approved quality improvement and utilization management programs • Assists in the development and implementation of physician education with respect to clinical issues and policies • Interfaces with physicians and other providers to facilitate implementation of recommendations to improve utilization and health care quality • Represents the business unit at appropriate state committees and other ad hoc committees

Requirements

• Medical Doctor or Doctor of Osteopathy • 7+ years of clinical experience in the practice of medicine • Utilization Management experience and knowledge of quality accreditation standards preferred • Actively practices medicine • Coursework 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 Texas 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