Corporate Medical Director

🔥 16 minutes ago

🇺🇸 United States – Remote

💵 $246.1k - $344.2k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

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

• The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals • Advises executives to develop functional strategies on matters of significance • Exercises independent judgment and decision making on complex issues regarding job duties and related tasks • Reviews health claims and clinical requests to determine the appropriateness and medical necessity of services provided • Evaluates requests involving Home Care Solutions, Skilled Nursing Facility services, Durable Medical Equipment, rehabilitation, discharge planning, and other home-based care solutions • Analyze complex clinical scenarios and variable factors to determine the most appropriate course of action

🎯 Requirements

• Doctor of Medicine (MD/DO) degree from an accredited university in the USA • Current and ongoing board certification in an approved ABMS Medical Specialty • Active unrestricted license in at least one jurisdiction • Willing to obtain additional licenses, as required, for various states in region of assignment • 2+ years of project leadership experience • 5+ years of direct clinical patient care experience post-residency or fellowship • No current sanction from Federal or State Governmental organizations • Excellent verbal and written communication skills with analytic and interpretative skills from prior experience focusing on quality, utilization, and/or case management • Knowledge and experience with national guidelines such as NCD/LCD, MCG® or InterQual

🏖️ Benefits

• Benefits starting day 1 of employment • Competitive 401k match • Generous Paid Time Off accrual • Tuition Reimbursement • Parental Leave