Medical Director

Centene
Arizona
Workplace: RemoteFull timeUSD 225,700 - 428,900 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Education: professionalSkills: ["Medical leadership","Clinical collaboration","Quality improvement focus","Utilization management knowledge","Leadership in physician committees"]

Lead and coordinate medical management for the business unit by assisting the Chief Medical Director with utilization management, medical quality improvement, and credentialing. Conduct medical reviews for complex cases, support performance improvement initiatives for capitated providers, and help set quality and cost-effectiveness goals. Collaborate with clinical teams, network providers, appeals staff, and consultants; represent the business unit on medical philosophy and state committees as needed.

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Centene
Centene
2 days ago

Medical Director

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Source: Company careers pageValidated by: Fursa AI
Last checked: 21 hours agoStatus: Live

Job Summary

Lead and coordinate medical management for the business unit by assisting the Chief Medical Director with utilization management, medical quality improvement, and credentialing. Conduct medical reviews for complex cases, support performance improvement initiatives for capitated providers, and help set quality and cost-effectiveness goals. Collaborate with clinical teams, network providers, appeals staff, and consultants; represent the business unit on medical philosophy and state committees as needed.
Location: Arizona
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 functions for the business unit.
  • •Provide medical leadership of utilization management, cost containment, and medical quality improvement activities.
  • •Perform medical reviews for utilization review, quality assurance, and medical review of complex, controversial, or experimental services.
  • •Support performance improvement initiatives for capitated providers and assist in planning goals and policies to improve quality and cost-effectiveness of care.
  • •Collaborate with clinical teams, network providers, appeals team, and medical and pharmacy consultants for complex cases and medical necessity appeals.

Pay and Benefits

Salary: USD 225,700 - 428,900 annually
Perks:Health Insurance401kPaid LeavePaid Holidays

Key Requirements

  • •Board Certified Physician.
  • •Current state license as a MD or DO in Arizona without restrictions, limitations, or sanctions.
  • •Medical Doctor or Doctor of Osteopathy (actively practices medicine).
  • •Utilization Management experience and knowledge of quality accreditation standards 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.
Education:Professional (JD, MD, etc.)
Skills:Medical leadershipClinical collaborationQuality improvement focusUtilization management knowledgeLeadership in physician committees
Licenses:Current Arizona medical license (MD or DO)
Certifications:Board certified medical specialty

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