Talent.com
Remote- Medical Director Arizona
Remote- Medical Director ArizonaCentene Corporation • Casper, WY, US
Remote- Medical Director Arizona

Remote- Medical Director Arizona

Centene Corporation • Casper, WY, US
9 days ago
Job type
  • Full-time
  • Part-time
  • Remote
Job description

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 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
  • Board certified in Internal Medicine 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
  • Consults on MCO clinical policy related to Substance Use Disorders and the cases of individual members for the MCM program on a routine basis.
  • Performs other duties as assigned
  • Complies with all policies and standards
  • 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 Psychiatry specialty Is required.) Current Arizona state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

    Pay Range : $221,300.00 - $420,500.00 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 • Casper, WY, US

    Related jobs
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,051 to $2,251 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,051 to $2,251 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Titan Medical Group to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.Titan Medical is looking for travelers to fill a Travel Med Surg position for a 13 w...Show more
    Last updated: 15 hours ago • Promoted • New!
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,975 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,975 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with OneStaff Medical to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.An independently-owned, nationally-recognized and amazingly awesome staffing firm ready...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,948 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,948 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with GetMed Staffing to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.GetMed Staffing is searching for a strong MedSurg RN to assist our traveler-friendly cli...Show more
    Last updated: 6 days ago • Promoted
    Travel Nurse - RN - MS - Medical Surgical - $2094.71 / Week

    Travel Nurse - RN - MS - Medical Surgical - $2094.71 / Week

    Medical Solutions • Casper, WY, US
    Full-time
    Medical Solutions is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Casper, WY. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $...Show more
    Last updated: 15 hours ago • Promoted • New!
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,047 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,047 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time +1
    TravelNurseSource is working with Nationwide Therapy Group to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.NTG is committed to matching you to the right position and we pride ourselves o...Show more
    Last updated: 4 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,771 to $1,964 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,771 to $1,964 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package,...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,162 per week in Riverton, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,162 per week in Riverton, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with FlexCare to find a qualified Med / Surg RN in Riverton, Wyoming, 82501!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With access t...Show more
    Last updated: 5 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,094 per week in Casper, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,094 per week in Casper, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Medical Solutions to find a qualified Med / Surg RN in Casper, Wyoming, 82601!.A facility in Casper, WY is seeking its next amazing RN (Registered Nurse) to work in ...Show more
    Last updated: 15 hours ago • Promoted • New!
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,952 per week in Casper, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,952 per week in Casper, WY

    TravelNurseSource • Casper, WY, US
    Full-time
    TravelNurseSource is working with Medical Solutions to find a qualified Med / Surg RN in Casper, Wyoming, 82601!.A facility in Casper, WY is seeking its next amazing RN (Registered Nurse) to work in ...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,033 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,033 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with FlexCare to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With access to ...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,162 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,162 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with FlexCare to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With access to ...Show more
    Last updated: 8 days ago • Promoted
    Travel Nurse - RN - MS - Medical Surgical - $2094.71 / Week - Hiring Now

    Travel Nurse - RN - MS - Medical Surgical - $2094.71 / Week - Hiring Now

    Medical Solutions • Casper, WY, US
    Full-time
    Medical Solutions is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Casper, WY. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $...Show more
    Last updated: 15 hours ago • Promoted • New!
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,782 to $1,976 per week in Casper, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $1,782 to $1,976 per week in Casper, WY

    TravelNurseSource • Casper, WY, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified Med / Surg RN in Casper, Wyoming, 82601!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package,...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,218 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,218 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Cynet Health to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.Job Title : Med / Surg Nurse Profession : RN Specialty : Med Surg Duration : 6 Weeks Shif...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,132 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,132 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Medical Solutions to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.A facility in Lander, WY is seeking its next amazing RN (Registered Nurse) to work in ...Show more
    Last updated: 4 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Malone Healthcare to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.RAPID • • • SH 400 SH SAGEWEST HEALTH CARE - Travel : RN Med Surg Nights (Riverton) job in...Show more
    Last updated: 8 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,252 per week in Rock Springs, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,252 per week in Rock Springs, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Medical Solutions to find a qualified Med / Surg RN in Rock Springs, Wyoming, 82901!.A facility in Rock Springs, WY is seeking its next amazing RN (Registered Nurse)...Show more
    Last updated: 7 days ago • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,031 per week in Lander, WY

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,031 per week in Lander, WY

    TravelNurseSource • Casper, Wyoming, US
    Full-time
    TravelNurseSource is working with Triage Staffing to find a qualified Med / Surg RN in Lander, Wyoming, 82520!.Travel Nursing : Med / Surg Lander. Shift Details : 12H Nights (7 : 00 PM-7 : 00 AM).Length : ...Show more
    Last updated: 8 days ago • Promoted