Remote Otter LogoRemoteOtter

Remote Market Place Medical Director

Posted 3 days ago
All others
Full Time
Worldwide
$231,900.00 - $440,500.00/year

Overview

As a clinical professional on the Medical Management/Health Services team, you will assist the Chief Medical Director in directing and coordinating medical management and quality improvement functions, impacting 28 million members.

In Short

  • Direct and coordinate medical management and quality improvement functions.
  • Provide medical leadership for utilization management and cost containment.
  • Perform medical review activities for complex and controversial services.
  • Support performance improvement initiatives for capitated providers.
  • Collaborate with clinical teams and network providers.
  • Conduct regular rounds for high-risk patient care coordination.
  • Participate in provider network development and market expansion.
  • Assist in physician education on clinical issues and policies.
  • Review claims for medical necessity and appropriate payment.
  • Develop alliances with the provider community.

Requirements

  • Medical Doctor or Doctor of Osteopathy required.
  • Utilization Management experience preferred.
  • Active practice of medicine is necessary.
  • Coursework in Health Administration or related fields is advantageous.
  • Experience with culturally diverse populations preferred.
  • Board certification in a recognized medical specialty.
  • Current unrestricted state license as MD or DO.

Benefits

  • Competitive pay and comprehensive benefits package.
  • Health insurance and 401K plans.
  • Tuition reimbursement and paid time off.
  • Flexible work schedules including remote options.
  • Equal opportunity employer committed to diversity.
Centene Management Company logo

Centene Management Company

Centene Management Company LLC is a diversified national organization dedicated to transforming the health of communities by providing high-quality healthcare solutions to its 28 million members. With a focus on building strong partnerships between health plans and provider networks, Centene emphasizes optimal performance in care delivery, quality improvement, and cost utilization. The company values diversity and offers a comprehensive benefits package, including competitive pay, flexible work arrangements, and support for employee development. Centene is committed to helping individuals and families live healthier lives through innovative programs and a wide range of health solutions.

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