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Chief Medical Director, Medicare

Company: Centene Corporation
Location: Tulsa
Posted on: April 2, 2024

Job Description:

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

  • Serve as a strategic clinical thought leader for the product, by driving outstanding results in clinical affordability, quality, population health, growth, Net Promoter Score (NPS), and clinical initiatives.
    • Focus on driving incremental reductions in avoidable admissions and readmissions, continuous improvement of HEDIS measures, reduction of unnecessary ER visits, appropriate prescription drug spend, and mitigation of provider abrasion from prior authorization and inpatient management programs.
      • Collaborate with the product team and matrix partners to design, implement, and drive programs that align with and achieve goals for the product.
      • Take a macro-level view of utilization management responsibilities to optimize clinical resource allocation and improve operational efficiency by collaborating effectively with the UM partners.
      • Identify and deliver relevant clinical and quality KPIs/metrics that are aligned with the strategic direction of the organization.
      • Serve as a subject matter expert on the product and associated healthcare delivery trends and practices.
      • Engage in regular analysis of medical care cost and utilization data, and partner with key stakeholders to inform and deliver HBR initiatives.
      • Actively engage with other leaders in the company to ensure an integrated, cross-departmental, data-driven clinical approach to population health for our members.
      • Support the development and implementation of quality improvement, care management, and disease management programs to drive value through improved healthcare outcomes and reduced costs.
      • Develop and maintain relationships with key stakeholders, including providers, payers, and government agencies.
      • Performs other duties as assigned.
      • Complies with all policies and standards.Education/Experience: Medical Doctor or Doctor of Osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists. 7+ years relevant experience. Previous experience as Medical Director is preferred. Master's degree in business administration, Public Health, Healthcare Administration or related field preferred.License/Certificates: Board Certification through American Board of Medical Specialists. Current state medical license without restrictions.Pay Range: $289,700.00 - $550,500.00 per yearCentene 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. Total compensation may also include additional forms of incentives.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.

Keywords: Centene Corporation, Tulsa , Chief Medical Director, Medicare, Executive , Tulsa, Oklahoma

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