Medical Director, Marketplace

Centene Corporation

Clinical professional directing and coordinating medical management and quality improvement. Assisting in managing care for 28 million members while collaborating with clinical and provider teams.

Posted 7/30/2026full-timeRemote • Iowa, Mississippi, Montana, New York, Tennessee • 🇺🇸 United StatesLead💰 $236,500 - $449,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical management, quality improvement, and utilization management, with a focus on cost containment and performance improvement initiatives. Possesses strong leadership skills to collaborate with clinical teams and enhance care for high-risk patients.

Highest-signal resume keywords

Medical Doctor (MD) or Doctor of Osteopathy (DO)Utilization Management ExperienceBoard Certification in Medical SpecialtyCurrent State License as MD or DOExperience with Culturally Diverse Populations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Review ActivitiesQuality AssurancePerformance Improvement InitiativesClinical Quality Improvement StudiesComplex Case Review

Soft Skills

CollaborationLeadershipCommunication

Certifications & Qualifications

Board Certification in Medical SpecialtyCertification in Internal or Family Medicine

Industry Keywords

Quality Accreditation StandardsHealth AdministrationHealth FinancingInsurance ManagementCredentialing Functions

About the role

Key responsibilities & impact

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.
Provide medical leadership for utilization management, cost containment, and medical quality improvement activities.
Perform medical review activities for utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Support effective implementation of performance improvement initiatives for capitated providers.
Assist Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness.
Provide medical expertise in the operation of approved quality improvement and utilization management programs.
Conduct regular rounds to assess and coordinate care for high-risk patients.
Collaborate with clinical teams and providers for reviewing complex cases and appeals.
Participate in provider network development and new market expansion.
Assist in the development and implementation of physician education on clinical issues.
Identify clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice.
Interface with physicians and providers to facilitate recommendations for improvement.

Requirements

What you’ll need

Medical Doctor or Doctor of Osteopathy
Utilization Management experience and knowledge of quality accreditation standards preferred
Actively practices medicine
Course work in Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous
Experience treating or managing care for a culturally diverse population preferred
Board certification in a medical specialty recognized by the American Board of Medical Specialists or American Osteopathic Association’s Department of Certifying Board Services
Certification in Internal or Family Medicine preferred
Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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