Medical Director – Acute Rehab

🕒 May 15

🇺🇸 United States – Remote

💵 $223.8k - $313.1k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Provide medical interpretation and determinations on acute inpatient rehabilitation authorization requests, ensuring alignment with national clinical guidelines, CMS requirements, Humana policies, and clinical standards. • Collaborate with team members, other departments, Humana colleagues, and clinical leadership to support the review process and facilitate quality outcomes. • Participate in and complete structured and mentored training programs; utilize ongoing team support during daily work activities. • Consistently apply critical thinking and maintain high standards in documentation and decision-making within a structured work environment. • Exercise independence in fulfilling enterprise expectations and meeting compliance timelines.

🎯 Requirements

• MD or DO degree • 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and related to acute inpatient rehabilitation. • Board Certified in an approved ABMS or AOA Medical Specialty with continued certification throughout employment. • A current and unrestricted license in at least one jurisdiction and willing to obtain additional license(s). • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. • Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, and acute inpatient rehabilitation. • Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers. • Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid. • Physical Medicine and Rehabilitation, Internal Medicine, Family Practice, Geriatrics, or Hospitalist background

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance and many other opportunities