Remote Inpatient Medicare Medical Director

About the role

Centene is seeking a Remote Inpatient Medicare Medical Director to join its Medical Management/Health Services team. In this senior clinical position you will help shape care for 28 million members by leading utilization management, quality improvement, and credentialing initiatives.

Key responsibilities

• Assist the Chief Medical Director in directing medical management, quality improvement, and credentialing functions.
• Provide medical leadership for utilization management, cost containment, and quality improvement activities.
• Conduct medical reviews of complex, controversial, or experimental services and ensure timely decision‑making.
• Support performance‑improvement initiatives for capitated providers and develop physician education programs.
• Participate in provider network development, new market expansion, and high‑risk patient rounds.
• Collaborate with care management, appeals, medical, and pharmacy teams on complex cases and medical necessity appeals.
• Identify utilization and quality trends, evaluate adverse patterns, and recommend improvements.
• Represent the business unit on state and ad‑hoc committees and, when needed, at public forums.

Required profile

• Board‑certified physician with extensive experience in Medicare inpatient care.
• Proven expertise in utilization management, medical review, and quality improvement.
• Strong ability to work collaboratively with multidisciplinary teams and external providers.
• Willingness to work weekends or holidays as required to support business operations.

Required skills

What we offer

• Competitive benefits package.
• Flexible remote work environment.
• Opportunity to impact care for millions of members.