OneHome - Medical Director - Part Time

Humana; Teletrabalho; BRL 1.197.000 - 1.676.000; Tempo integral

Resumo da oferta

A major healthcare provider in Brazil is looking for a Medical Director to ensure compliance with national guidelines and oversee patient care. The ideal candidate will have an MD or DO degree, board certification, and over 5 years of clinical experience. This role requires strong communication skills and the ability to work in a dynamic environment. Benefits include paid time off and a 401(k) plan.

Serviços

Paid time off

401(k) retirement savings plan

Employee assistance program

Qualificações

• 5+ years of direct clinical patient care experience post residency or fellowship.
• No sanctions from Federal or State Governmental organizations.
• The ability to pass credentialing requirements.

Responsabilidades

• Identify medical management operational improvements.
• Participate in call rotation including weekend coverage.
• Develop collaborative relationships with Team and key partners.

Conhecimentos

MD or DO degree

Current board certification

Excellent verbal and written communication skills

Participate in educational activities

Formação académica

MD or DO degree

Descrição da oferta de emprego

Become a part of our caring community and help us put health first

The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.

Medical Directors will learn Medicare and Medicare Advantage requirements and understand how to operationalize this knowledge in their daily work. They work in a structured environment with expectations for consistency in thinking, authorship, meeting departmental expectations, and compliance timelines.

Use your skills to make an impact

Required Qualifications

• MD or DO degree
• Current and ongoing board certification through an approved ABMS or AOABPS Medical Specialty is a requirement. NBPAS certification is not accepted.
• A current and unrestricted license in at least one jurisdiction and willingness to obtain license, as required, for various states in region of assignment.
• 5+ years of direct clinical patient care experience post residency or fellowship.
• No sanctions from Federal or State Governmental organizations.
• The ability to pass credentialing requirements.
• Excellent verbal and written communication skills with analytic and interpretative skills.
• Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution.

Preferred Qualifications

• Experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).
• Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care or hospital based clinical specialists.
• Ability to function in a dynamic fast paced environment.
• Commitment to a culture of innovation.
• Passionate about contributing to an organization’s focus on consistency in outcomes, consumer experiences, and a highly engaged team culture.
• Knowledge and experience with national guidelines such as NCD/LCD, MCG® or InterQual.

Other duties

• Identify medical management operational improvements, including those within the medical director area.
• Participate in call rotation which includes weekend coverage.
• Develop collaborative relationships with Team and key partners within the Medicare Line of Business.
• Support Home Solutions as needed.
• Other activities as assigned by the managing Medical Director.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours: 1

Pay Range: $223,800 - $313,100 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.