Medical Director, Behavioral Health – Medicaid

🔥 0 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – 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

• Responsible for behavioral health care strategies and/or operations • Make determinations regarding requested services and levels of care • Learn and operationalize Medicaid requirements in daily work • Conduct computer-based review of clinical scenarios and records • Communicate decisions to internal associates • Discuss determinations with external physicians and stakeholders • Support Humana values and collaborate on team activities • May require coverage for vacations, weekends, and holidays

🎯 Requirements

• Doctor of Medicine or Doctor of Osteopathy • Board-certified in an ABMS recognized specialty of Psychiatry • A current and unrestricted license in at least one jurisdiction • Willing to obtain additional license, if required • At least five years of experience post-training providing clinical services • Experience in utilization management review and case management in a health plan setting • No current sanction from Federal or State Governmental organizations • Able to pass credentialing requirements

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off, company and personal holidays • Volunteer time off • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Many other opportunities