Talent.com
Pediatric & Family Medicine Medical Director - Florida
Pediatric & Family Medicine Medical Director - FloridaCentene Corporation • Orlando, FL, US
Pediatric & Family Medicine Medical Director - Florida

Pediatric & Family Medicine Medical Director - Florida

Centene Corporation • Orlando, FL, US
2 days ago
Job type
  • Full-time
  • Part-time
Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

We’re Hiring : Full time and & Part time Remote Pediatric and Family Medicine Medical Directors

Centene Corporation is a leading provider of government-sponsored healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families served by the Health Insurance Marketplace.

Looking for a compelling opportunity to move beyond patient encounters and drive meaningful change in the community?

Qualifications for this role include :

  • MD or DO without restrictions
  • Must reside in Florida
  • Board certified in Pediatrics or Family Medicine
  • Utilization Management experience and knowledge of quality accreditation standards.
  • Actively practices medicine

Position Purpose :

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

  • Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
  • Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
  • Supports effective implementation of performance improvement initiatives for capitated providers.
  • Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
  • Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
  • Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
  • Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
  • Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
  • Participates in provider network development and new market expansion as appropriate.
  • Assists in the development and implementation of physician education with respect to clinical issues and policies.
  • Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit / payment components.
  • Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
  • Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
  • Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
  • Develops alliances with the provider community through the development and implementation of the medical management programs.
  • As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
  • Represents the business unit at appropriate state committees and other ad hoc committees.
  • May be required to work weekends and holidays in support of business operations, as needed.
  • Education / Experience :

    Medical Doctor or Doctor of Osteopathy. Utilization Management experience and knowledge of quality accreditation standards preferred. Actively practices medicine. Course work in the areas of Health Administration, Health Financing, Insurance, and / or Personnel Management is advantageous. Experience treating or managing care for a culturally diverse population preferred.

    License / Certifications :  Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services. (Certification in Pediatrics or Family Medicine required.) Current Florida Sate license as a MD or DO without restrictions, limitations, or sanctions from government programs.

    Full-time Pay Range : $231,900.00 - $440,500.00 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

    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

    Create a job alert for this search

    Medical Director Florida • Orlando, FL, US

    Related jobs
    Medical Director, Pediatric Surgery at AdventHealth Tampa

    Medical Director, Pediatric Surgery at AdventHealth Tampa

    AdventHealth Central Florida • Orlando, FL, US
    Full-time
    AdventHealth for Children and AdventHealth Medical Group are looking for a dynamic and energetic full time Pediatric Surgery leader to join our team at AdventHealth Tampa.This is a wonderful opport...Show more
    Last updated: 8 hours ago • Promoted • New!
    Emergency Medicine Assistant Medical Director in Altamonte Springs, FL

    Emergency Medicine Assistant Medical Director in Altamonte Springs, FL

    TeamHealth Corporate • Altamonte Springs, FL, US
    Full-time
    Advance your career in Central Florida! TeamHealth has an emergency department (ED) assistant medical director position open for a board certified emergency medicine (EM) physician to join the team...Show more
    Last updated: 8 hours ago • Promoted • New!
    Medical Director, Academic Faculty Opportunity - FM and NMM at AdventHealth East Orlando

    Medical Director, Academic Faculty Opportunity - FM and NMM at AdventHealth East Orlando

    AdventHealth Central Florida • Orlando, FL, US
    Full-time
    AdventHealth Graduate Medical Education in Orlando, Florida is looking for a dynamic, hardworking, and broadly skilled Family Medicine physician with a passion for teaching to serve as our Medical ...Show more
    Last updated: 8 hours ago • Promoted • New!
    Medical Director - Regional

    Medical Director - Regional

    Envision Physician Services - ANES • Orlando, FL, US
    Full-time +1
    Envision Physician Services is seeking a full-time Anesthesiologist to serve as the Regional Medical Director (RMD) for our Orlando Health System facilities in the Orlando area.This is an exception...Show more
    Last updated: 8 hours ago • Promoted • New!
    Medical Director - Orlando, Florida

    Medical Director - Orlando, Florida

    Gpac • Goldenrod, Florida, United States
    Full-time
    Quick Apply
    I am seeking a Medical Director for a full-service veterinary hospital that places the care, diagnosis, and treatment of pets as their primary concern. The individual in this role will manage the ho...Show more
    Last updated: 30+ days ago
    Medical Director, Pediatric Cardiac Critical CareAdventHealth for Children - Orlando, Florida

    Medical Director, Pediatric Cardiac Critical CareAdventHealth for Children - Orlando, Florida

    AdventHealth Medical Group • Orlando, FL, Orange County, FL; Florida, United States
    Full-time
    The Walt Disney Pavilion at AdventHealth for Children is looking for an experienced Pediatric Cardiac Intensivist to help lead the division of pediatric cardiac intensive care at AdventHealth for C...Show more
    Last updated: 7 hours ago • Promoted • New!
    Rheumatology Medical Director Orlando Health in Orlando, Florida

    Rheumatology Medical Director Orlando Health in Orlando, Florida

    Orlando Health, Inc. • Orlando, FL, US
    Full-time
    The Medical Director of Rheumatology will provide leadership, along with oversight for the creation and development of the Rheumatology department at Orlando Health. This role involves strategic pla...Show more
    Last updated: less than 1 hour ago • Promoted • New!
    Medical Director, Pediatric Cardiac Critical Care - AdventHealth for Children - Orlando, Florida

    Medical Director, Pediatric Cardiac Critical Care - AdventHealth for Children - Orlando, Florida

    AdventHealth Central Florida • Orlando, Florida, United States
    Full-time
    The Walt Disney Pavilion at AdventHealth for Children is looking for an experienced Pediatric Cardiac Intensivist to help lead the division of pediatric cardiac intensive care at AdventHealth for C...Show more
    Last updated: 2 days ago • Promoted
    Medical Director, Pediatric Cardiac Critical Care AdventHealth for Children - Orlando, Florida

    Medical Director, Pediatric Cardiac Critical Care AdventHealth for Children - Orlando, Florida

    AdventHealth Medical Group • Orlando, US
    Full-time
    The Walt Disney Pavilion at AdventHealth for Children is looking for an experienced Pediatric Cardiac Intensivist to help lead the division of pediatric cardiac intensive care at AdventHealth for C...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director of Cutaneous Oncology Program (Orlando Health in Central Florida)

    Medical Director of Cutaneous Oncology Program (Orlando Health in Central Florida)

    Orlando Health, Inc. • Lake Mary, FL, US
    Full-time
    Orlando Health Cancer Institute - Lake Mary, FL.The Orlando Health Cancer Institute is seeking a BE / BC Surgical Oncologist for an exceptional leadership opportunity as Medical Director of the Cutan...Show more
    Last updated: less than 1 hour ago • Promoted • New!
    Medical Director

    Medical Director

    National Veterinary Associates • ORLANDO, Florida, United States
    Permanent
    Managing Veterinarian – AAHA-Accredited Small Animal Hospital – Orlando, FL.Are you ready to lead a passionate veterinary team in one of Florida’s most vibrant cities? We’re seeking a.Managing Vete...Show more
    Last updated: 30+ days ago • Promoted
    NP / Medical Director / Florida / Locum tenens / Medical Director in Orlando, FL Job

    NP / Medical Director / Florida / Locum tenens / Medical Director in Orlando, FL Job

    Samuel Contract Staffing LLC • Orlando, FL, US
    Full-time
    Medical Director needed in Orlando, FLI work with a plasma center in Orlando, FL.We have an open position for a Pathologist (AP / CP) to join us 4 hours a week. Must be within 50 miles of the clinic.D...Show more
    Last updated: 30+ days ago • Promoted
    Locum Physician (MD / DO) - Emergency Medicine in Apopka, FL

    Locum Physician (MD / DO) - Emergency Medicine in Apopka, FL

    LocumJobsOnline • Apopka, FL, US
    Full-time +1
    LocumJobsOnline is working with VISTA Staffing to find a qualified Emergency Medicine MD in Apopka, Florida, 32712!.This position with one of VISTA's healthcare partners in.Schedule : Days, nights, ...Show more
    Last updated: 30+ days ago • Promoted
    Locum Physician (MD / DO) - Family Practice in Central Florida, FL

    Locum Physician (MD / DO) - Family Practice in Central Florida, FL

    LocumJobsOnline • Central Florida, FL, US
    Full-time
    LocumJobsOnline is working with All Medical Personnel to find a qualified Family Practice MD in Central Florida, Florida, 32771!. Focus on patients and help them achieve better health in onsite corp...Show more
    Last updated: 30+ days ago • Promoted
    Pediatric & Family Medicine Medical Director -Florida

    Pediatric & Family Medicine Medical Director -Florida

    Centene Corporation • Orlando, FL, Orange County, FL; Florida, United States
    Full-time +1
    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offe...Show more
    Last updated: 7 hours ago • Promoted • New!
    Center Medical Director in Orlando Making $360,000

    Center Medical Director in Orlando Making $360,000

    Optigy Group • Orlando, FL, United States
    Full-time
    Center Clinical Director Primary Care in Orlando, FL making $380,000 +Optigy - Orlando, FL, United StatesCenter Clinical Medical Director - Primary Care Outpatient Orlando, FLCOMPENSATION : $280-$30...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director of Leukemia Needed in Downtown Orlando, Florida

    Medical Director of Leukemia Needed in Downtown Orlando, Florida

    Orlando Health, Inc. • Orlando, FL, US
    Full-time
    The Medical Director of Leukemia will provide leadership and oversight for the Leukemia Program at Orlando Health.This role involves strategic planning, program development, and ensuring the delive...Show more
    Last updated: 8 hours ago • Promoted • New!
    Family Medicine Opportunity - Orlando, FL

    Family Medicine Opportunity - Orlando, FL

    National Health Partners • Orlando, FL, US
    Full-time
    Join a Well-Established Family Medicine Practice in Beautiful Orlando, FL (Near University of Central Florida).We are seeking a Board Certified or Board Eligible Family Medicine physician to join a...Show more
    Last updated: 30+ days ago • Promoted