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Supervisory Medical Director, Inpatient UM & Appeals
Location
Missouri
Posted
167 days ago
Salary
$236.5K - $449.3K / year
Seniority
Lead
Job Description
Supervisory Medical Director, Inpatient UM & Appeals
Centene Corporation Group
• 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
Job 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
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