Medical Director

Job Description

Join Centene Corporation as a Medical Director and play a pivotal role in shaping the future of healthcare. In this leadership position, you will collaborate with the Chief Medical Director to direct and coordinate medical management, quality improvement, and credentialing functions within the business unit. Your expertise will drive utilization management, cost containment, and medical quality improvement initiatives, ensuring timely and quality decision-making. You will support the effective implementation of performance improvement programs for capitated providers and assist in planning and establishing goals to enhance the quality and cost-effectiveness of care for members. As a medical expert, you will contribute to approved quality improvement and utilization management programs, adhering to regulatory, state, corporate, and accreditation standards. Additionally, you will participate in physician committees, conduct regular rounds to assess and coordinate care for high-risk patients, collaborate with clinical teams and network providers, and assist in provider network development and physician education. This role also involves identifying utilization review studies, evaluating trends in medical service utilization, and developing alliances with the provider community. Represent the business unit on medical issues locally and nationally and at state committees.

Qualifications

1. Medical Doctor or Doctor of Osteopathy. 2. Preferred experience in Utilization Management and knowledge of quality accreditation standards. 3. Actively practicing medicine. 4. Advantageous coursework in Health Administration, Health Financing, Insurance, and/or Personnel Management. 5. Preferred experience treating or managing care for culturally diverse populations. 6. 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. 7. Preferred certification in Internal or Family Medicine specialty. 8. Current 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