Job Description

Job Description

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose:
Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members. This is a hybrid role requiring the incumbent to reside in Michigan and work onsite three days a week, and two remotely.

• Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
• Provide leadership and expertise in the development, implementation and interpretation of medical review and quality related policies and guidelines.

• Provide oversight and direction for staff and provider training and education.
• Promote positive relations with the local medical community, including periodic consultation with providers or prescribers.
• Review case management data, identifies trends and gaps in care and recommends corrective actions.
• Review all quality of care issues and oversees the development and implementation of processes for improvement.
• Monitor performance indicators to ensure the delivery of cost-effective care within quality standards.
• Monitor member and provider satisfaction and recommends and implements changes to improve satisfaction levels.
• Work collaboratively to develop corporate clinical care standards and medical practice policies.
• Provide medical guidance to the Medical Management department.

Education/Experience:

Medical Doctor (MD) or Doctor of Osteopathy required

7+ years clinical experience in the practice of medicine required

Management experience preferred

Utilization Management experience and knowledge of quality accreditation standards preferred

Actively practices medicine and provides leadership in the local medical community preferred

Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management preferred
Experience treating or managing care for a culturally diverse population preferred

Licenses/Certifications:
Board certification in a medical specialty recognized by the American Board of Medical Specialists required. Michigan state medical license required.

Pay Range: $287,700.00 - $546,700.00 per 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 flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Tags

Work at office, Local area, Remote work, Flexible hours, 3 days per week,

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