Title: Remote National Medical Director Location: United States Job Description: You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. - Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. - Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. - Supports effective implementation of performance improvement initiatives for capitated providers. - Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. - Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. - Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. - Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. - Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. - Participates in provider network development and new market expansion as appropriate. - Assists in the development and implementation of physician education with respect to clinical issues and policies. - Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. - Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. - Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. - Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. - Develops alliances with the provider community through the development and implementation of the medical management programs. - As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. - Represents the business unit at appropriate state committees and other ad hoc committees. - May be required to work weekends and holidays in support of business operations, as needed. Education/Experience: - Medical Doctor or Doctor of Osteopathy. Utilization Management experience and knowledge of quality accreditation standards preferred. - Actively practices medicine. - Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. - Experience treating or managing care for a culturally diverse population preferred. License/Certifications: - 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. - Certification in Internal or Family Medicine, preferred. - Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs. Pay Range: $236,500.00 - $449,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

• Lead Omada’s Clinical Quality department across program quality, accreditation, safety, health equity, and clinical quality analytics. • Own the operational effectiveness of Omada’s clinical quality infrastructure and the quality performance of core programs, including program-level outcomes. • Define and drive the near-term roadmap for program quality, Clinical Quality & Outcomes Committee (CQOC) priorities, accreditation readiness, quality analytics, and AI bias monitoring. • Translate strategic and emerging priorities into clear quality systems, ownership structures, monitoring standards, and improvement plans. • Serve as the senior leader accountable for the integrity and performance of Omada’s clinical program model across products and care experiences. • Ensure programs are clinically coherent, evidence-based, measurable, aligned to client and member expectations, and improving over time. • Build durable quality infrastructure that goes beyond governance committees and retrospective review to support a growing portfolio of clinical products and care experiences. • Partner closely across Care Delivery, Product, Engineering, Commercial, Compliance, Legal/Regulatory, Data Analytics, and Applied AI leaders to solve cross-functional problems and strengthen Omada’s clinical quality operating system. • Help shape the clinical quality components of Omada’s co-intelligence engine, including the data foundation and knowledge layers needed to better understand member trajectories, behavior change readiness, treatment adherence, biomarker trends, and signals of underperformance. • Advance proactive quality capabilities over time, including predictive risk identification, smarter personalization of interventions, more precise experimentation, and faster scaling of what works. • Oversee clinical quality governance for AI-enabled products, workflows, and decision-support tools, including monitoring for quality, bias, safety, transparency, and performance. • Lead and develop future program-level clinical owners and subject matter experts (SMEs) across cardiometabolic programs including obesity, weight management, GLP-1, diabetes, hypertension, and cholesterol programs. • Represent Omada’s clinical quality strategy and standards with external stakeholders, including clients, employer and health plan partners, accrediting bodies, and other strategic audiences, while helping strengthen market credibility, support commercial conversations, and translate clinical rigor into external trust and growth opportunities.

• Serve as the Lead Clinical Programmer on Pulmovant sponsored clinical trials, utilizing Veeva CDMS, Medidata RaveEDC, and/or InForm as the primary electronic data capture (EDC) solutions. • Perform hands-on design and build of Case Report Forms (CRFs), associated visit matrices, edit checks, rules and custom functions, or alternatively, oversee a Contract Research Organization (CRO) that performs these activities. • Select and maintain clinical data tools, including performing product validation for the organization. • Integrate multiple other critical clinical data products into EDC (e.g., Interactive Response Technology, electronic Patient Reported Outcomes, etc.) via API or other methods. • Lead User Acceptance Testing (UAT) process for a cross-functional team, including authoring UAT plans and other required validation documentation. • Participate in protocol review and study design discussion as subject matter expert on CDISC/CDASH best practices. • Work closely with the Head of Clinical Data Management and other Biometrics leaders to build and maintain a growing global library of SDTM/CDASH compliant CRFs, edit checks, and downstream reports, listings, and visualizations. • Perform and validate data migrations and/or post-production database changes needed after initial database go-live. • Program project-specific metrics reporting, working across the project team to ensure reports meet the needs of all internal and external stakeholders. • Author and maintain appropriate Standard Operating Procedures (SOPs) that govern the database build, handling, transfer, and cleaning processes. • Oversee clinical database build timelines, in concert with the Lead Clinical Data Manager, Project Manager, and other critical study team members. • Author and maintain Data Transfer Agreements with external vendors, in addition to being point of contact for any incoming or outgoing clinical data transfers via a secure method. • Heavily support data management activities, including data review and cleaning, query resolution, data reconciliation, authoring Data Management documentation, and coordination of database freeze/lock deliverable. • Train internal and external stakeholders on clinical database functionality as needed. • Perform and own the user management process at a study-level. • Primary point of contact for organization as business owner of multiple vendors, including notably the clinical database vendors. • Oversee and drive vendor governance in this capacity. • Own clinical data aggregation process and select appropriate technology tools to enable this (e.g., Veeva CDB).

• Draft, revise, and edit scientific publications, including manuscripts for peer-reviewed journals as well as abstracts, posters, and oral presentations for medical conferences. • Collaborate with Publication Planning team to coordinate kick-off calls with Investigators and establish timelines for the development of publications. • Work with internal stakeholders to ensure publications are clear, accurate, and aligned with strategic goals. • Participate in meetings with clinical trial investigators and key opinion leaders for the review and revision of drafts and to manage the editing and revision process, ensuring timely completion of scientific publications. • Keep current with the latest information, trends, and developments in target therapy areas, and perform literature searches as needed for drafting publications. Interpret literature information relevant to scientific publications. Understand, assimilate, and interpret data and other sources of information with appropriate guidance/direction from authors and therapeutic teams. • Remain current on industry and company requirements and best practices as they relate to scientific publications. • Understand and follow applicable company publication policy and procedures and act as a subject matter expert regarding internal processes and relevant publication guidelines.