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    • Medical Director - Topeka - Centene Corporation

    Centene Corporation
    Centene Corporation Topeka

    3 weeks ago

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    Description

    Medical Director

    Clinical leaders like you drive change for our 28 million members by joining our Medical Management/Health Services team at Centene Corporation. We offer a fresh perspective on workplace flexibility and competitive benefits.

    Job Summary

    The Medical Director assists the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing functions for the business unit.

    Main Responsibilities

    • Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
    • Perform medical review activities related to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
    • Support effective implementation of performance improvement initiatives for capitated providers.
    • Assist the Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.

    Key Duties

    • Operate approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
    • Participate in provider network development and new market expansion as appropriate.
    • Develop alliances with the provider community through medical management programs.
    • Represent the business unit before various publics on medical philosophy, policies, and related issues.

    Requirements

    • Medical Doctor or Doctor of Osteopathy degree.
    • Utilization Management experience and knowledge of quality accreditation standards preferred.
    • Actively practicing medicine with coursework in Health Administration, Health Financing, Insurance, and/or Personnel Management advantageous.

    Licenses and Certifications

    • 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.
    • Current Kansas state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

    Benefits

    We offer a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements.

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