National Neonatology Medical Director

Title: National Remote Medical Director, Neonatology

Location: Remote – Missouri (MO)
Remote
Full-time

Job Description

You could be the one who changes everything for Centene’s 28 million members. As a national, diversified healthcare organization, Centene offers competitive benefits and a flexible approach to work.

Position Purpose

The National Neonatology Medical Director provides high-impact leadership to drive innovative, member-centric solutions that shape the future of neonatal care. This role collaborates with stakeholders, aligns clinical and strategic goals, and supports the Deputy Chief Health Officer in directing medical management, quality improvement, and credentialing functions within Centene’s national NICU Pod.

Key Responsibilities

• Provide medical leadership across utilization management, cost containment, and medical quality improvement activities.

• Perform medical review activities involving utilization review, quality assurance, and complex or experimental services; ensure timely and accurate decisions.

• Support implementation of performance improvement initiatives for capitated providers.

• Assist in planning and establishing goals/policies to improve care quality and cost-effectiveness.

• Provide medical expertise for quality improvement and utilization management programs per regulatory and accreditation standards.

• Support physician committee operations (structure, processes, membership).

• Conduct regular rounds for high-risk neonatal patients and coordinate care with clinical teams.

• Collaborate with care management, network providers, medical/pharmacy consultants, and appeals teams on complex cases and medical necessity reviews.

• Participate in provider network development and new market expansion when appropriate.

• Assist with developing physician education regarding clinical issues and policies.

• Identify utilization review studies and evaluate adverse utilization trends and provider practice patterns.

• Identify clinical quality improvement studies to reduce unwarranted variation and improve outcomes.

• Interface with physicians/providers to implement recommendations that improve quality and utilization.

• Review complex or unusual claims to determine medical necessity and appropriate payment.

• Build alliances with provider communities through implementation of medical management programs.

• Represent the business unit externally on medical philosophy, policy, or related issues as needed.

• Represent the organization at state-level or ad hoc committees.

• May work weekends or holidays as required.

Education & Experience

• Medical Doctor (MD) or Doctor of Osteopathy (DO).

• Utilization Management experience and knowledge of accreditation standards preferred.

• Actively practicing physician.

• Coursework in Health Administration, Financing, Insurance, or Personnel Management is advantageous.

• Experience treating or managing care for culturally diverse populations preferred.

Licensure / Certifications

• Board Certification in Neonatology (ABMS or AOA-recognized).

• Current, unrestricted medical license (MD or DO).

Compensation

Pay Range: $231,900 – $440,500 per year
Actual pay may vary based on skills, experience, education, job-related factors, and full/part-time status.
Total compensation may include additional incentives.

Benefits

Centene offers a comprehensive benefits package including:

• Competitive pay

• Health insurance

• 401(k) & stock purchase plans

• Tuition reimbursement

• Paid time off + holidays

• Flexible remote/hybrid/field/office options

Benefits may be subject to eligibility.

Equal Opportunity Statement

Centene is committed to diversity and inclusion. All qualified applicants will be considered regardless of protected characteristics. Applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the CA Fair Chance Act.