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 26 million members.

• 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 or Doctor of Osteopathy. 7+ years of clinical experience in the practice of medicine. Management experience preferred. Utilization Management experience and knowledge of quality accreditation standards preferred. Actively practices medicine and provides leadership in the local medical community. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is desired. Experience treating or managing care for a culturally diverse population preferred.

License/Certification: Board certification in a medical specialty recognized by the American Board of Medical Specialists. (Certification in a primary care specialty preferred.) Current state license as a MD or DO without restrictions, limitations or sanctions from government programs.

For Illinois plan only: Must reside in Illinois. Must have a minimum of 8 years of experience practicing medicine. Will oversee Contractor’s clinical strategy and clinical programs (both physical and behavioral health). Will be responsible for Utilization Management Program, Care Coordination, Long Term Services and Support, quality improvement, accreditation, credentialing, pharmacy, Appeals and Grievances, health services, Behavioral Health services, and medical policy. Will manage Quality Assessment and Performance Improvement Program. Will attend all quarterly quality meetings.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.