Chief Medical Officer, Ambetter

Chief Medical Director, Product

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 : Chief medical director, product provides strategic and clinical leadership to the relevant product (Ambetter) at Centene. Serve as the clinical leader for the product as a member of the Ambetter executive team. In partnership with shared services, drive clinical strategy and implementation of initiatives focused on medical expense cost, quality, population health, growth, and member experience. Specifically, focus on driving incremental reductions in unnecessary ER visits and avoidable admissions and readmissions, continuous improvement of HEDIS measures, appropriate prescription drug spend, and mitigation of provider abrasion from prior authorization and inpatient management programs. Engage in regular analysis of medical care cost and utilization data, and partner with key stakeholders to inform and deliver HBR initiatives. Take a macro-level view of utilization management responsibilities to optimize clinical resource allocation and improve operational efficiency by collaborating effectively with shared service UM partners. Support the development and implementation of quality improvement, care management, and chronic condition management programs to drive value through improved healthcare outcomes and reduced costs. Identify and deliver relevant clinical and quality KPIs / metrics that are aligned with the strategic direction of the product and organization. Collaborate with the product team and matrix partners to design, implement, and drive programs that align with and achieve goals for the product. Serve as a subject matter expert on the product and associated healthcare delivery trends and practices. Actively engage with other leaders in the company to ensure an integrated, cross-LOB, data-driven clinical approach to population health for our members. Develop and maintain relationships with key stakeholders, including providers, payers, and government agencies.

Education / experience : medical doctor (MD) or doctor of osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists required. Master's Degree in business administration, public health, healthcare administration or related field preferred. 7+ years relevant experience required. Previous experience as medical director preferred. Board certification through American Board of Medical Specialists. Current state medical license without restrictions.

Pay range : $271,000.00 - $515,500.00 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.