Remote Behavioral Medical Director – Eastern Region

About the role

Centene is seeking a Remote Behavioral Medical Director for its Eastern Region to provide clinical leadership across medical management, utilization review, and quality improvement initiatives for its 28 million members.

Key responsibilities

• Assist the Chief Medical Director in directing medical management, quality improvement, and credentialing functions.
• Lead utilization management and cost‑containment activities, ensuring timely medical review of complex, controversial, or experimental services.
• Conduct regular rounds for high‑risk patients, collaborating with care‑management teams to optimize outcomes.
• Partner with clinical teams, network providers, appeals teams, and medical/pharmacy consultants on complex cases and medical‑necessity appeals.
• Support performance‑improvement initiatives for capitated providers and contribute to physician committee operations.
• Identify utilization trends, unusual provider practices, and opportunities for clinical quality improvement.
• Represent the business unit on state and ad‑hoc committees and, when needed, at public forums.
• May work weekends and holidays to support business operations.

Required profile

Required skills

What we offer

• Competitive benefits and flexible workplace options.
• Opportunity to impact care for millions of members.