Senior Medical Director – YouthCare
Location
Illinois
Posted
16 days ago
Salary
$225.7K - $428.9K / year
Seniority
Senior
Job Description
Senior Medical Director – YouthCare
Centene Corporation Group
• 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
Job Requirements
- 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
- 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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