Remote Behavioral Medical Director

Overview of the Remote Behavioral Medical Director Role

In this position at Centene Corporation, the Remote Behavioral Medical Director will play a pivotal role in supporting the health and well-being of the company's 28 million members. This unique opportunity allows a clinical professional to significantly impact medical management and health services, ensuring quality patient care while focusing on medical leadership in utilization management, quality improvement, and credentialing functions.

Responsibilities

The responsibilities of this role encompass a broad range of essential functions designed to enhance the overall quality of healthcare delivery. Key tasks include:

• Assist the Chief Medical Director in directing and coordinating medical management processes.
• Provide leadership in utilization management, aiming to achieve effective cost containment and medical quality improvement.
• Conduct medical review activities related to utilization review and quality assurance.
• Support performance improvement initiatives tailored for capitated providers.
• Assist in establishing strategic goals and policies to augment the quality and cost-effectiveness of care provided to members.
• Collaborate with care management teams for optimizing patient outcomes, especially for high-risk patients.
• Interact effectively with various clinical teams, including providers and pharmacy consultants, to review complex medical cases and medical necessity appeals.
• Participate in the development of provider networks and explore new market expansions.
• Engage in identifying utilization review studies and evaluating adverse trends.
• Provide clinical education to physicians regarding policy-related clinical issues.
• Represent the business unit in state committees and forums addressing relevant medical philosophies and policies.

Required Skills and Qualifications

Prospective applicants must meet specific educational and professional criteria to qualify for this position. Key qualifications include:

• Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited institution.
• Proven experience in utilization management and familiarity with quality accreditation standards is highly preferred.
• Active practice of medicine is mandatory.
• Coursework in Health Administration, Health Financing, and related fields is considered advantageous.
• Experience in managing care for culturally diverse populations is preferred.
• Board certification by the American Board of Psychiatry and Neurology is required.
• A current, unrestricted state medical license with no limitations or sanctions is necessary, with an Illinois license preferred.

Salary and Benefits

The salary range for this position is quite competitive, with a pay scale of $231,900.00 to $440,500.00 annually. Actual compensation will vary based on several factors including individual skills, experience, education level, and employment status (full-time or part-time).

Centene values its employees and offers a robust benefits package, which includes:

• Competitive pay and comprehensive health insurance.
• Access to 401K and stock purchase plans.
• Tuition reimbursement programs.
• Generous paid time off along with holidays.
• A favorable approach to work flexibility arrangements, allowing for remote, hybrid, or office work schedules.

Work Environment and Equality Commitment

Centene Corporation is dedicated to creating a diverse environment and is an equal opportunity employer. The company seeks to reflect a workforce that embodies various perspectives, offering opportunities irrespective of race, color, religion, gender, sexual orientation, or nationality.

Qualified applicants will also be considered for employment under the LA County Ordinance and the California Fair Chance Act concerning past arrest or conviction records. Centene emphasizes its commitment to ensuring that all voices are heard and that diversity is celebrated across its teams.

Conclusion

In conclusion, the Remote Behavioral Medical Director role at Centene Corporation is an excellent opportunity for qualified medical professionals looking to make a significant impact in the healthcare space. With a focus on leadership within medical management, this role not only provides a chance to improve healthcare delivery for millions but also offers an attractive salary and a valuable benefits package. Interested candidates should consider how their qualifications align with the position's requirements and take the next step in advancing their careers within a company committed to both excellence in patient care and workplace diversity.

This job offer was originally published on himalayas.app