Oklahoma City, Oklahoma

Position Purpose: Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members.

  • Provide leadership and expertise in the development, implementation and interpretation of medical review and quality related policies and guidelines.
  • Provide oversight and direction for staff and provider training and education.
  • Promote positive relations with the local medical community, including periodic consultation with providers or prescribers.
  • Review case management data, identifies trends and gaps in care and recommends corrective actions.
  • Review all quality of care issues and oversees the development and implementation of processes for improvement.
  • Monitor performance indicators to ensure the delivery of cost-effective care within quality standards.
  • Monitor member and provider satisfaction and recommends and implements changes to improve satisfaction levels.
  • Work collaboratively to develop corporate clinical care standards and medical practice policies.
  • Provide medical guidance to the Medical Management department.

  • Education/Experience: Medical Doctor or Doctor of Osteopathy. 7+ years of clinical experience in the practice of medicine. Management experience preferred. Utilization Management experience and knowledge of quality accreditation standards preferred. Actively practices medicine and provides leadership in the local medical community. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is desired. Experience treating or managing care for a culturally diverse population preferred.

    License/Certification: Board certification in a medical specialty recognized by the American Board of Medical Specialists. (Certification in a primary care specialty preferred.) Current state license as a MD or DO without restrictions, limitations or sanctions from government programs.

    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.

    Oklahoma City, Oklahoma

    Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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