Chief Medical Officer, Ohio

Centene Corporation•Columbus, OH

13d

About The Position

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. Position Purpose: Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members. Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations. 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.

Requirements

Medical Doctor (MD) or Doctor of Osteopathy required.
7+ years clinical experience in the practice of medicine required.
Active Board certification in a medical specialty recognized by the American Board of Medical Specialists required.
Current OH state license (OR ABLE TO OBTAIN ONE) as a MD or DO without restrictions, limitations or sanctions from government programs required.

Nice To Haves

Management experience preferred.
Utilization Management experience and knowledge of quality accreditation standards preferred.
Actively practices medicine and provides leadership in the local medical community preferred.
Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management preferred.
Experience treating or managing care for a culturally diverse population preferred.

Responsibilities

Provide medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members.
Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
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.