Centene is transforming the health of ourcommunities one person at a time. As an Executive on our team, youcould be the one who changes everything for our 28 millionmembers.
Position Purpose : Provide medical oversight, expertise and leadership to ensure thedelivery of cost effective, quality healthcare services to healthplan members.
- Serves as clinical advisor to andeducator of medical management staff making sure correct clinicaljudgment is applied to all medical managementdeterminations.
- Provideleadership and expertise in the development, implementation andinterpretation of medical review and quality related policies andguidelines.
- Provideoversight and direction for staff and provider training andeducation.
- Promotepositive relations with the local medical community, includingperiodic consultation with providers orprescribers.
- Review casemanagement data, identifies trends and gaps in care and recommendscorrective actions.
- Reviewall quality of care issues and oversees the development andimplementation of processes forimprovement.
- Monitorperformance indicators to ensure the delivery of cost-effectivecare within qualitystandards.
- Monitor memberand provider satisfaction and recommends and implements changes toimprove satisfactionlevels.
- Workcollaboratively to develop corporate clinical care standards andmedical practicepolicies.
- Provide medicalguidance to the Medical Managementdepartment.
Education / Experience : Medical Doctor or Doctorof Osteopathy. 7+ years of clinical experience in the practice ofmedicine.
Management experience preferred. Utilization Managementexperience and knowledge of quality accreditation standardspreferred.
Actively practices medicine and provides leadership inthe local medical community. Course work in the areas of HealthAdministration, Health Financing, Insurance, and / or PersonnelManagement is desired.
Experience treating or managing care for aculturally diverse populationpreferred.
License / Certification : Board certification in a medical specialty recognized by theAmerican Board of Medical Specialists.
Certification in a primarycare specialty preferred.) Current state license as a MD or DOwithout restrictions, limitations or sanctions from governmentprograms.
Pay Range : $282,100.00 - $536,000.00per year Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans,tuition reimbursement, paid time off plus holidays, and a flexibleapproach to work with remote, hybrid, field or office workschedules.
Actual pay will be adjusted based on an individual'sskills, experience, education, and other job-related factorspermitted by law.
Total compensation may also include additionalforms of incentives.
Centene is an equalopportunity employer that is committed to diversity, and values theways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color,religion, sex, sexual orientation, gender identity, nationalorigin, disability, veteran status, or other characteristicprotected by applicablelaw.
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