Chief Medical Officer

Centene Corporation

3d•Hybrid

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. We are hiring a Chief Medical Officer for Louisiana Healthcare Connections, a subsidiary of Centene Corproration. This is a hybrid role with a mix of remote, in-office engagement (Baton Rouge) and minor travel within the state. Qualifications for this role include: MD or DO without restrictions Board Certified Physician Louisiana license Louisiana resident Medicaid experience highly preferred 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.
Board Certified Physician
Louisiana license
Louisiana resident

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.
Medicaid experience highly 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.