Centene Corporation
10,000+ employees
Founded 1984
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
Healthcare Insurance • Non-profit • Social Impact
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
Senior Medical Director – YouthCare
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Centene Corporation
10,000+ employees
Founded 1984
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
Healthcare Insurance • Non-profit • Social Impact
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
📋 Description
• 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
🎯 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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