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• C

  Remote National Medical Director  

  Centene

  - Mirando City

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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.Active American Board 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Mirando City, TX-78369 Read Less

  Apply Now
• C

  Remote National Medical Director  

  Centene

  - San Antonio

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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.Active American Board 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:San Antonio, TX-78212 Read Less

  Apply Now
• C

  Remote Medical Director, Appeals  

  Centene

  - Underwood

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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:

  Active 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 and / or Family Medicine specialty, 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Underwood, WA-98651 Read Less

  Apply Now
• C

  Remote National Medical Director  

  Centene

  - Carlton

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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.Active American Board 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Carlton, TX-76436 Read Less

  Apply Now
• C

  Remote Medical Director, Appeals  

  Centene

  - Lincoln

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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:

  Active 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 and / or Family Medicine specialty, 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Lincoln, WA-99147 Read Less

  Apply Now
• C

  Remote National Medical Director  

  Centene

  - Afton

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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.Active American Board 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Afton, TX-79220 Read Less

  Apply Now
• C

  Remote Medical Director, Appeals  

  Centene

  - Trout Lake

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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:

  Active 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 and / or Family Medicine specialty, 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Trout Lake, WA-98650 Read Less

  Apply Now
• C

  Remote Medical Director, Appeals  

  Centene

  - Auburn

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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:

  Active 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 and / or Family Medicine specialty, 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Auburn, WA-98002 Read Less

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• C

  Remote National Medical Director  

  Centene

  - Ladonia

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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.Active American Board 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Ladonia, TX-75449 Read Less

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• C

  Remote Medical Director, Appeals  

  Centene

  - Quincy

  Posted: 15/05/2026

  Apply Now

  You could be the one who changes everything for our 28 million members... Read More

  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:

  Active 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 and / or Family Medicine specialty, 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

  Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
  See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

  PandoLogic. Category:Healthcare, Keywords:Medical Director, Location:Quincy, WA-98848 Read Less

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