Senior Medical Director – YouthCare

Centene Corporation

Senior Medical Director leading medical affairs for Illinois Health Plan at Centene Corporation. Overseeing medical leadership and quality improvement activities for Medicaid and Medicare members.

Posted 6/7/2026full-timeRemote • Illinois • 🇺🇸 United StatesSenior💰 $225,700 - $428,900 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

utilization managementmedical reviewquality assurancecost containmentmedical quality improvementperformance improvement initiativescase managementpharmacy managementmedical necessity appealsprovider network development

Soft Skills

leadershipcoordinationplanninggoal settingpolicy establishmentcommunicationmanagement

Certifications & Qualifications

MDDOBoard Certified PediatricianBoard Certified Family Medicinelicensed in Illinois

Industry Keywords

medical affairsdenials and appealsclinical experiencequality accreditation standardsactive practice of medicinemedical directorscapitated providersnew market expansion

About the role

Key responsibilities & impact

Assist the Vice President of Medical Affairs to direct and coordinate the medical affairs functions for the business unit
Oversee the denials and appeals department
May manage other medical directors
Provide medical leadership for all utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities
Perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services
Support the effective implementation of performance improvement initiatives for capitated providers
Assist VPMA in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members
Utilize the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals
Participate in provider network development and new market expansion as appropriate

Requirements

What you’ll need

MD or DO without restrictions
Board Certified Pediatrician or Family Medicine
Must be licensed in Illinois
Must reside in Illinois
7+ years of clinical experience in the practice of medicine
Management experience preferred
Utilization Management experience and knowledge of quality accreditation standards preferred
Active practice of medicine

Benefits

Comp & perks

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