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Chief Medical Director

Centene
$236,500–$449,300/yr

  • Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.
  • Provide medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
  • Perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.

Utilization Management
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Medical Director (Utilization Management)

HJ Staffing
US

  • Evaluating hospital admissions, continued stays, and post-acute services for Medicare Advantage members.
  • Guide timely care determinations using CMS regulations and evidence-based practices.
  • Lead discussions with attending physicians to clarify clinical documentation and support appropriate levels of care.

HJ Staffing is seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. The company has not provided any information about its size/employees and culture but is likely a medium to large medical or staffing company.

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