Talent.com
Remote Medical Director Indiana

Remote Medical Director Indiana

Centene CorporationFort Wayne, IN, US
19 hours ago
Job type
  • Full-time
  • Part-time
  • Remote
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 : Remote 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 :

  • Licenses MD or DO in Indiana without restrictions
  • Board certified by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Service
  • 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. Current Indiana state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

    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 • Fort Wayne, IN, US

    Related jobs
    • Promoted
    Psychiatry

    Psychiatry

    KPG Provider ServicesFort Wayne, Indiana, US
    Full-time +1
    Psychiatry physician employment in Indiana : Inpatient Facility : Looking for an experienced Medical Director - Psychiatry in the Fort Wayne, Indiana area. Below you will find the Position Overview w...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $31 to $49 per hour in Huntington, IN

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $31 to $49 per hour in Huntington, IN

    TravelNurseSourceHuntington, IN, US
    Full-time
    TravelNurseSource is working with Patterns LLC to find a qualified Med / Surg RN in Huntington, Indiana, 46750!.Our unit places a high emphasis on delivering exceptional care.We are team focused, dri...Show moreLast updated: 13 days ago
    • Promoted
    Medical Director in Fort Wayne, IN

    Medical Director in Fort Wayne, IN

    TeamHealth CorporateFort Wayne, IN, US
    Permanent
    TeamHealth has an excellent hospitalist medical director physician position available at Maple Heights Behavioral Health hospital in Ft. Ideal candidates will be family medicine or med-peds trained ...Show moreLast updated: 30+ days ago
    • Promoted
    Staff RN, Emergency Department (Van Wert)

    Staff RN, Emergency Department (Van Wert)

    OhioHealthVan Wert, OH, US
    Part-time
    We are more than a health system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to...Show moreLast updated: 28 days ago
    • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,290 per week in Columbia City, IN

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $2,290 per week in Columbia City, IN

    TravelNurseSourceColumbia City, IN, US
    Full-time
    TravelNurseSource is working with Medical Solutions to find a qualified Med / Surg RN in Columbia City, Indiana, 46725!.A facility in Columbia City, IN is seeking its next amazing RN (Registered Nurs...Show moreLast updated: 11 days ago
    • Promoted
    • New!
    Travel Nurse - RN - LD - Labor and Delivery - $2299 / Week

    Travel Nurse - RN - LD - Labor and Delivery - $2299 / Week

    Fusion Medical StaffingHuntington, IN, US
    Full-time
    Fusion Medical Staffing is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Huntington, IN. Shift : Inquire Start Date : 12 / 01 / 2025 Duration : 13 weeks P...Show moreLast updated: 1 hour ago
    • Promoted
    Medical Director Physician

    Medical Director Physician

    KPG Provider ServicesFort Wayne, IN, US
    Full-time
    Inpatient Facility : Looking for an experienced Medical Director - Psychiatry in the Fort Wayne, Indiana area.Below you will find the Position Overview with all the detail regarding the position.Pos...Show moreLast updated: 30+ days ago
    • Promoted
    Travel MRI Tech - $2,155 to $2,477 per week in Indianapolis, IN

    Travel MRI Tech - $2,155 to $2,477 per week in Indianapolis, IN

    AlliedTravelCareersFort Wayne, Indiana, US
    Full-time
    AlliedTravelCareers is working with Fusion Medical Staffing to find a qualified MRI Tech in Indianapolis, Indiana, 46202!. Facility in Indianapolis, Indiana.Fusion Medical Staffing is seeking a skil...Show moreLast updated: 30+ days ago
    • Promoted
    Infection Prevention Medical Director

    Infection Prevention Medical Director

    Parkview HealthFort Wayne, US
    Full-time
    Board Eligible / Board Certified.Infection Prevention & Epidemiology team in.Specifics of Your Role as a Medical Director. Full time position with flexibility on the balance of administrative and cl...Show moreLast updated: 30+ days ago
    • Promoted
    Infection Prevention Medical Director

    Infection Prevention Medical Director

    HealthEcareers - ClientFort Wayne, IN, USA
    Full-time
    Board Eligible / Board Certified.Infection Prevention & Epidemiology team in.Specifics of Your Role as a Medical Director. Full time position with flexibility on the balance of administrative and cl...Show moreLast updated: 30+ days ago
    • Promoted
    Infectious Disease- Fort Wayne, Indiana

    Infectious Disease- Fort Wayne, Indiana

    CHSPSC, LLC.Fort Wayne, IN, US
    Permanent
    MD / DO) to join an established practice.Applicants should be patient-centered with excellent interpersonal and clinical skills, and motivated to work collaboratively to expand an already thriving, w...Show moreLast updated: 30+ days ago
    • Promoted
    Travel MRI Tech - $2,491 per week in Indianapolis, IN

    Travel MRI Tech - $2,491 per week in Indianapolis, IN

    AlliedTravelCareersFort Wayne, Indiana, US
    Full-time
    AlliedTravelCareers is working with GetMed Staffing to find a qualified MRI Tech in Indianapolis, Indiana, 46202!.GetMed Staffing is searching for a strong MRI Tech to assist our traveler-friendly ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $98 to $108 per hour in Columbia City, IN

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $98 to $108 per hour in Columbia City, IN

    TravelNurseSourceColumbia City, IN, US
    Full-time
    TravelNurseSource is working with Patterns LLC to find a qualified Med / Surg RN in Columbia City, Indiana, 46725!.Bedside nurse position for CCU and Med / Surg population (units combined).Duties would...Show moreLast updated: 10 days ago
    • Promoted
    Urgent Care / Occ. Med Medical Director in Fort Wayne

    Urgent Care / Occ. Med Medical Director in Fort Wayne

    CHSPSC, LLC.Fort Wayne, IN, US
    Permanent
    Fort Wayne, IN is an ideal area for families, with a low cost of living, lakes, vibrant neighborhoods, and that big city, small-town feel. This position replaces our current medical director wh...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - ICU - Intensive Care Unit - $1423 / Week - Hiring Now

    Travel Nurse - RN - ICU - Intensive Care Unit - $1423 / Week - Hiring Now

    Medical SolutionsDecatur, IN, US
    Full-time
    Medical Solutions is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Decatur, IN. Shift : 2x12 hr nights Start Date : ASAP Duration : 13 weeks Pay : $14...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $90 to $100 per hour in Kendallville, IN

    Travel Registered Nurse (RN) - Medical-Surgical (Med / Surg) - $90 to $100 per hour in Kendallville, IN

    TravelNurseSourceKendallville, IN, US
    Full-time
    TravelNurseSource is working with Patterns LLC to find a qualified Med / Surg RN in Kendallville, Indiana, 46755!.General RN duties – assessments, care plans, med passes, ADLs, charting, patient educ...Show moreLast updated: 10 days ago
    • Promoted
    • New!
    Travel Nurse - RN - LD - Labor and Delivery - $2299 / Week - Hiring Now

    Travel Nurse - RN - LD - Labor and Delivery - $2299 / Week - Hiring Now

    Fusion Medical StaffingHuntington, IN, US
    Full-time
    Fusion Medical Staffing is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Huntington, IN. Shift : Inquire Start Date : 12 / 01 / 2025 Duration : 13 weeks P...Show moreLast updated: 1 hour ago
    • Promoted
    Travel Nurse - RN - ICU - Intensive Care Unit - $1423 / Week

    Travel Nurse - RN - ICU - Intensive Care Unit - $1423 / Week

    Medical SolutionsDecatur, IN, US
    Full-time
    Medical Solutions is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Decatur, IN. Shift : 2x12 hr nights Start Date : ASAP Duration : 13 weeks Pay : $14...Show moreLast updated: 30+ days ago