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Medical Director

Louisiana Healthcare Connections · Vega del Codorno

🇬🇧 English

Job description

About the role

Centene is seeking a Medical Director to join its Medical Management/Health Services team and help shape care for 28 million members. This senior clinical leader will work closely with the Chief Medical Officer to drive utilization management, quality improvement, and cost‑containment initiatives across the business unit.

Key responsibilities

  • Assist the CMO in directing medical management, quality improvement, and credentialing functions.
  • Lead utilization management, cost containment, and medical quality improvement activities.
  • Conduct medical reviews of complex, controversial, or experimental services and ensure timely decision‑making.
  • Support performance‑improvement initiatives for capitated providers.
  • Participate in physician committee governance and structure.
  • Perform regular rounds for high‑risk patients, collaborating with care‑management teams.
  • Collaborate with network providers, appeals teams, and medical/pharmacy consultants on complex cases.
  • Contribute to provider network development and new market expansion.
  • Develop and deliver physician education on clinical issues and policies.
  • Identify utilization trends, adverse patterns, and opportunities for clinical quality improvement.

Required profile

  • MD or DO without restrictions.
  • Licensed to practice in Louisiana.
  • Board‑certified physician.

Required skills

    What we offer

    • Competitive benefits package.
    • Flexibility in workplace arrangements.
    • Opportunity to impact care for millions of members.

    Questions fréquentes

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    Published 4 months ago

    23 views · 0 interested

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    Louisiana Healthcare Connections

    Vega del Codorno