Centene

1 week ago

Remote Behavioral Medical Director, Eastern Region

✓ Verified Job

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

Source: Company careers pageValidated by: Fursa AI

Last checked: 9 hours agoStatus: Live

Job Summary

Lead and coordinate medical management, quality improvement, and credentialing for the business unit. Provide medical leadership for utilization management, cost containment, and medical quality improvement, conducting complex medical reviews and utilization/quality assessments. Support performance improvement for capitated providers, collaborate with clinical teams, providers, appeals teams, and consultants, and help shape physician committees, provider education, and market expansion while assisting the Chief Medical Director.

Location: Missouri, Georgia, South Carolina, North Carolina, Ohio, Indiana

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 support timely decisions.
•Support performance improvement initiatives for capitated providers and help establish goals and policies to improve quality and cost-effectiveness of care.
•Collaborate with care management teams, network providers, appeals teams, and medical/pharmacy consultants; conduct rounds for high-risk patients and help develop physician education and committee processes.

Pay and Benefits

Salary: USD 236,500 - 449,300 annually

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Must be a Medical Doctor (MD) or Doctor of Osteopathy (DO).
•Provide board certification by the American Board of Psychiatry and Neurology.
•Maintain a current state license as an MD or DO without restrictions, limitations, or sanctions.
•Have utilization management experience and knowledge of quality accreditation standards (preferred) and actively practice medicine.
•Coursework in Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous (and culturally diverse patient experience is preferred).

Education:Professional (JD, MD, etc.)

Skills:Medical leadershipQuality improvementUtilization reviewCollaborationCare coordination

Licenses:Current state license as a MD or DO without restrictions, limitations, or sanctions

Certifications:Board certification by the American Board of Psychiatry and NeurologyCertification in Child 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

1 week ago

Remote Behavioral Medical Director, Eastern Region

✓ Verified Job

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

Source: Company careers pageValidated by: Fursa AI

Last checked: 9 hours agoStatus: Live

Job Summary

Location: Missouri, Georgia, South Carolina, North Carolina, Ohio, Indiana

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 support timely decisions.
•Support performance improvement initiatives for capitated providers and help establish goals and policies to improve quality and cost-effectiveness of care.
•Collaborate with care management teams, network providers, appeals teams, and medical/pharmacy consultants; conduct rounds for high-risk patients and help develop physician education and committee processes.

Pay and Benefits

Salary: USD 236,500 - 449,300 annually

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Must be a Medical Doctor (MD) or Doctor of Osteopathy (DO).
•Provide board certification by the American Board of Psychiatry and Neurology.
•Maintain a current state license as an MD or DO without restrictions, limitations, or sanctions.
•Have utilization management experience and knowledge of quality accreditation standards (preferred) and actively practice medicine.
•Coursework in Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous (and culturally diverse patient experience is preferred).

Education:Professional (JD, MD, etc.)

Skills:Medical leadershipQuality improvementUtilization reviewCollaborationCare coordination

Licenses:Current state license as a MD or DO without restrictions, limitations, or sanctions

Certifications:Board certification by the American Board of Psychiatry and NeurologyCertification in Child 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