Supervisory Medical Director, Inpatient UM & Appeals
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Montana • United States
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Salary
💰 $236,500 - $449,300 per year
Job Level
About the role
- Provide people leadership, coaching and mentorship for a team of front-line medical directors
- Support Chief Medical Officer in the execution of strategic clinical initiatives
- Participate in utilization review studies, evaluate adverse trends; and collaborate with CMO to develop solutions
- Handle complex and high-profile utilization management cases
- Conduct regular rounds to assess and coordinate care for high-risk patients
- Oversee and actively participate in the appeals process
- Collaborate closely with clinical teams, appeals team, and network providers to ensure understanding and adherence to utilization management policies
Requirements
- Medical Doctor (MD)
- Graduate of an accredited medical school required
- Master's Degree MBA, MPH, preferred
- 5+ years Managed care/ clinical experience; experienced with commercial, Medicare and Medicaid lines of business required
- 1+ years Supervisory/management experience preferred
- 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 required
- Certification in Internal or Family Medicine specialty preferred
- Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs required
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
utilization managementclinical initiativesutilization reviewadverse trend evaluationpatient care coordinationappeals process managementmanaged care experiencecommercial insuranceMedicareMedicaid
Soft skills
people leadershipcoachingmentorshipcollaborationcommunicationproblem-solvingteam managementstrategic thinkingassessmentcoordination
Certifications
Medical Doctor (MD)Master's Degree (MBA, MPH)Board certification in medical specialtyCertification in Internal MedicineCertification in Family MedicineCurrent state medical license (MD or DO)