Medical Director

Centene
Florida
Workplace: RemoteFull timeUSD 236,500 - 449,300 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Education: professionalSkills: ["Medical leadership","Quality improvement","Clinical decision making","Collaboration","Stakeholder communication"]

Lead medical management for a Florida health plan, primarily handling long-term care cases. Partner with the Chief Medical Director to direct and coordinate utilization management, cost containment, quality improvement, and credentialing activities. Conduct medical reviews for complex cases, support performance improvement for capitated providers, collaborate with clinical teams and consultants, and represent the business unit in physician committees and state committees as needed.

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FursaFursa
Centene
Centene
1 month ago

Medical Director

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Source: Company careers pageValidated by: Fursa AI
Last checked: 24 days agoStatus: Live

Job Summary

Lead medical management for a Florida health plan, primarily handling long-term care cases. Partner with the Chief Medical Director to direct and coordinate utilization management, cost containment, quality improvement, and credentialing activities. Conduct medical reviews for complex cases, support performance improvement for capitated providers, collaborate with clinical teams and consultants, and represent the business unit in physician committees and state committees as needed.
Location: Florida
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 activities for utilization review, quality assurance, and medical review of complex/controversial/experimental services
  • •Support performance improvement initiatives for capitated providers and help establish quality/cost-effectiveness goals and policies
  • •Coordinate care for high-risk patients, collaborate with clinical teams and consultants, and participate in physician committees and network development

Pay and Benefits

Salary: USD 236,500 - 449,300 annually
Perks:Health Insurance401kEquityPaid LeavePaid HolidaysRemote Work

Key Requirements

  • •MD or DO without restrictions
  • •Board certified physician in a recognized medical specialty
  • •Current Florida state license as an MD or DO without restrictions, limitations, or sanctions
  • •Florida resident
  • •Actively practices medicine or has been actively practicing within the last 5 years; Internal Medicine or Family Medicine preferred
Experience:HealthcareMedicaidMedicareHealth planUtilization management
Education:Professional (JD, MD, etc.)
Skills:Medical leadershipQuality improvementClinical decision makingCollaborationStakeholder communication
Licenses:Florida state medical license (MD or DO)
Certifications:Board Certified

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
WebsiteLinkedIn