Medical Director - California

October 4

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• Change healthcare delivery for 28 million members • Deliver medical and people leadership • Assist Senior Medical Director or Chief Medical Officer • Participate in quality improvement and medical management • Ensure high performance on quality metrics, cost control, and financial success • Build relationships with Preferred Provider Groups (PPGs) • Provide leadership, coaching, and mentorship to medical directors • Participate in utilization review studies • Handle complex utilization management cases • Conduct and participate in peer-to-peer reviews • Oversee and participate in the appeals process • Provide clinical guidance to care managers. • Collaborate with clinical teams and network providers.

Requirements

• Medical Doctor (MD) • Graduate of an accredited medical school required • Master's Degree MBA, MPH, or epidemiologist degree preferred • 5+ years Managed care/clinical experience; experienced with commercial, Medicare and Medicaid lines of business required • 1+ years Supervisory/management experience 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 required • Current California state license as a MD or DO without restrictions, limitations, or sanctions from government programs required.

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.