Talent.com
Remote Medical Director- New York
Remote Medical Director- New YorkCentene Corporation • New York, NY, US
No longer accepting applications
Remote Medical Director- New York

Remote Medical Director- New York

Centene Corporation • New York, NY, US
16 hours 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
  • Must be licensed in New York
  • 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.
  • Asssts 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 Psychiatry specialty Is required.) Current New York state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

    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 New • New York, NY, US

    Related jobs
    Director, Medical Insights & Analytics - (4 roles)

    Director, Medical Insights & Analytics - (4 roles)

    Novartis Group Companies • East Hanover, NJ, United States
    Full-time
    There are 4 Dir, Medical Insights & Analytics associated with this job posting.Dir, Medical Insights & Analytics, CRM.Dir, Medical Insights & Analytics, Immunology. Dir, Medical Insights & Analytics...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Medical Director / New York / Locum or Permanent / Director / MD - Finance Transformation

    Physician / Medical Director / New York / Locum or Permanent / Director / MD - Finance Transformation

    WCS Healthcare Partners • New York, NY, US
    Full-time
    Top Tier Management Consulting firm is looking to bring on Directors and Managing Directors to lead finance transformation initiatives for their clients as their business continues to grow.This is ...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Hematology / New York / Permanent / Director of Medical Oncology Opportunity in Northern

    Physician / Hematology / New York / Permanent / Director of Medical Oncology Opportunity in Northern

    All Star Healthcare Solutions • New York, NY, US
    Full-time
    Director of Medical Oncology Opportunity in Northern New York.Join a team of 2 medical oncologists and 2 advanced practice professionals. Partner with Radiation Oncologist and Oncologic Intervention...Show more
    Last updated: 30+ days ago • Promoted
    Senior Medical Director, Client Engagement and Virtual Care Outcomes Research

    Senior Medical Director, Client Engagement and Virtual Care Outcomes Research

    Teladoc Health • Purchase, NY, United States
    Full-time
    Teladoc Health is a global, whole person care company made up of a diverse community of people dedicated to transforming the healthcare experience. As an employee, you're empowered to show up every ...Show more
    Last updated: 30+ days ago • Promoted
    VP, Medical StrategyNew York, New York

    VP, Medical StrategyNew York, New York

    Ogilvy Health • New York, NY, US
    Full-time
    Ogilvy Health is focused on driving superior outcomes in the ever-changing healthcare environment, an increasingly complex and evolving marketplace. We inspire brands and people to impact the world ...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Medical Director / New York / Locum or Permanent / Psychiatry Residency Program Director

    Physician / Medical Director / New York / Locum or Permanent / Psychiatry Residency Program Director

    WCS Healthcare Partners • Staten Island, NY, US
    Full-time
    Academic and teaching hospital in Greater NYC looking to hire a Psychiatry Residency Program Director.Full time position with hospital benefits including PTO, CME, Malpractice coverage and competit...Show more
    Last updated: 30+ days ago • Promoted
    Director, Field Medical Training and ContentNewNew York, NY

    Director, Field Medical Training and ContentNewNew York, NY

    Axsome Therapeutics • New York, NY, US
    Permanent
    Job Opportunity at Axsome Therapeutics.Interested in building your career at Axsome Therapeutics? Get future opportunities sent straight to your email. Accepted file types : pdf, doc, docx, txt, rtf....Show more
    Last updated: 9 days ago • Promoted
    Medical Director Physician - Competitive Salary (New Rochelle)

    Medical Director Physician - Competitive Salary (New Rochelle)

    DocCafe • New Rochelle, NY, United States
    Full-time
    DocCafe has an immediate opening for the following position : Physician - Medical Director in New Rochelle, New York.DocCafe is the premier physician and advanced practice job board to help you adva...Show more
    Last updated: 3 days ago • Promoted
    Clinical Development Medical Director, Oncology Nuclear Medicine (MD)

    Clinical Development Medical Director, Oncology Nuclear Medicine (MD)

    Novartis Group Companies • East Hanover, NJ, United States
    Full-time
    As the Senior Clinical Development Medical Director (CDMD), you will lead the strategic planning and management of the assigned clinical program from an end-to-end clinical development perspective....Show more
    Last updated: 30+ days ago • Promoted
    Senior Medical Director - Psychiatrist - Remote Based

    Senior Medical Director - Psychiatrist - Remote Based

    Syneos Health / inVentiv Health Commercial LLC • New York, NY, United States
    Remote
    Full-time
    Senior Medical Director - Psychiatrist - Remote Based.Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success.We translate unique c...Show more
    Last updated: 13 days ago • Promoted
    Site Medical Director (New York)

    Site Medical Director (New York)

    Tandym Group • New York, NY, United States
    Full-time
    A healthcare organization in New York City is currently seeking a licensed Primary Care Physician to join their growing team as their new Site Medical Director at one of their facilities on Long Is...Show more
    Last updated: 20 days ago • Promoted
    Medical Director Physician

    Medical Director Physician

    All Star Healthcare Solutions • New York, NY, USA
    Full-time
    Medical Director Physician at All Star Healthcare Solutions summary : .The Medical Director Physician position is responsible for overseeing family medicine education and administration in a practice...Show more
    Last updated: 30+ days ago • Promoted
    Assistant Medical Director

    Assistant Medical Director

    Tandym Group • Queens, NY, United States
    Full-time
    A private organization in New York is currently seeking a licensed Physician, with a Family and / or Internal Medicine background, to join their team as their new Assistant Medical Director.Monday to...Show more
    Last updated: 23 days ago • Promoted
    Medical Director

    Medical Director

    IPG Health • Parsippany-Troy Hills, NJ, United States
    Full-time
    As a Medical Director, you will serve as a scientific expert and strategic partner, providing in-depth knowledge of assigned brands and therapeutic areas to inform brand communications.You'll colla...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director Physician

    Medical Director Physician

    DOCTORS CHOICE PLACEMENT SERVICES, INC. • Jersey City, NJ, USA
    Full-time
    Medical Director Physician at DOCTORS CHOICE PLACEMENT SERVICES, INC.The Medical Director Physician role involves overseeing primary care medical practices in New Jersey, focusing on the recruitmen...Show more
    Last updated: 30+ days ago • Promoted
    Director, Platform Enablement RLT & RLI (US Medical) 2 of 2

    Director, Platform Enablement RLT & RLI (US Medical) 2 of 2

    Novartis Group Companies • East Hanover, NJ, United States
    Full-time
    Location : Remote : This position can be based remotely in US.Please note that this role would not provide relocation as a result. The expectation of working hours and travel (domestic and / or internat...Show more
    Last updated: 27 days ago • Promoted
    Associate Medical Director, Rare Hematology

    Associate Medical Director, Rare Hematology

    Sanofi • MORRISTOWN, NJ, US
    Full-time
    Associate Medical Director, Rare Hematology.We are an innovative global healthcare company, committed to transforming the lives of people with immune challenges, rare diseases and blood disorders, ...Show more
    Last updated: 6 days ago • Promoted
    Medical Director - Multiple Openings / REMOTE

    Medical Director - Multiple Openings / REMOTE

    EmblemHealth • New York, NY, United States
    Remote
    Full-time
    Manage the daily clinical operation and administration of a Medical Management Department or function to support improved utilization results across the spectrum of medical specialties.Provide clin...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Medical Director / New York / Locum or Permanent / Associate Medical Director - Multispe

    Physician / Medical Director / New York / Locum or Permanent / Associate Medical Director - Multispe

    WCS Healthcare Partners • Long Island City, NY, US
    Full-time +1
    A multispecialty practice in New York City serving union employees is seeking a Family Medicine or Internal Medicine physician for their outpatient clinic in Queens. Main responsibilities include di...Show more
    Last updated: 30+ days ago • Promoted
    Regional Director – Physical Therapy (New York City & Westchester, NY)

    Regional Director – Physical Therapy (New York City & Westchester, NY)

    Sloane Stecker Physical Therapy PC • New York, NY, United States
    Full-time
    Sloane Stecker Physical Therapy has been improving the lives of clients of all ages and conditions for years through physical therapy, strength training, and advanced wellness programs.The ideal ca...Show more
    Last updated: 13 days ago • Promoted