Centene

3 weeks ago

Behavioral Health Medical Director

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 4 hours agoStatus: Live

Job Summary

Lead behavioral health medical management for a Texas market, assisting the Chief Medical Director to direct quality improvement, credentialing, and utilization management. Provide medical leadership for utilization review, cost containment, and medical quality initiatives, performing reviews of complex or experimental services. Partner with care management teams, physicians, network providers, and appeals and pharmacy consultants to improve outcomes, support performance improvement for capitated providers, and participate in physician committees, education, and state-level committees.

Location: Texas

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Director level

Key Responsibilities

•Assist the Chief Medical Director to direct and coordinate medical management, quality improvement, and credentialing for the business unit.
•Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
•Perform medical review for utilization review, quality assurance, and complex/controversial/experimental services to ensure timely decisions.
•Support performance improvement initiatives for capitated providers and help establish goals and policies to improve quality and cost-effectiveness of care.
•Conduct regular rounds for high-risk patients and collaborate with clinical teams, network providers, appeals, and medical/pharmacy consultants to optimize outcomes.

Pay and Benefits

Salary: USD 236,500 - 449,300 annually

Perks:Health Insurance401kEquityPaid Leave

Key Requirements

•Medical Doctor (MD) or Doctor of Osteopathy (DO).
•Board certification in Psychiatry is required (American Board of Psychiatry and Neurology).
•Current Texas state license as an MD or DO without restrictions, limitations, or sanctions.
•Utilization Management experience and knowledge of quality accreditation standards preferred.
•Actively practices medicine and has experience treating or managing culturally diverse populations (preferred).

Experience:HealthcareUtilization managementBehavioral health

Skills:LeadershipMedical reviewCross-functional collaborationQuality improvementDecision making

Licenses:Texas medical license (MD/DO)

Certifications:Board certification in Psychiatry

Company Brief

Centene

Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn

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Centene

3 weeks ago

Behavioral Health Medical Director

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 4 hours agoStatus: Live

Job Summary

Location: Texas

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Director level

Key Responsibilities

•Assist the Chief Medical Director to direct and coordinate medical management, quality improvement, and credentialing for the business unit.
•Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
•Perform medical review for utilization review, quality assurance, and complex/controversial/experimental services to ensure timely decisions.
•Support performance improvement initiatives for capitated providers and help establish goals and policies to improve quality and cost-effectiveness of care.
•Conduct regular rounds for high-risk patients and collaborate with clinical teams, network providers, appeals, and medical/pharmacy consultants to optimize outcomes.

Pay and Benefits

Salary: USD 236,500 - 449,300 annually

Perks:Health Insurance401kEquityPaid Leave

Key Requirements

•Medical Doctor (MD) or Doctor of Osteopathy (DO).
•Board certification in Psychiatry is required (American Board of Psychiatry and Neurology).
•Current Texas state license as an MD or DO without restrictions, limitations, or sanctions.
•Utilization Management experience and knowledge of quality accreditation standards preferred.
•Actively practices medicine and has experience treating or managing culturally diverse populations (preferred).

Experience:HealthcareUtilization managementBehavioral health

Skills:LeadershipMedical reviewCross-functional collaborationQuality improvementDecision making

Licenses:Texas medical license (MD/DO)

Certifications:Board certification in Psychiatry

Company Brief

Centene

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn