Part-Time Medical Director, Medicare Appeals (Remote)

Humana, Inc.; Dover (DE); Remoto; USD 224.000 - 313.000; Part-time

Vantaggi offerti da questo lavoro

Paid time off

401(k) retirement plan

Employee assistance program

Business travel and accident coverage

Descrizione del lavoro

Humana, Inc. seeks a Medical Director for a part-time, seasonal, non-benefitted hourly role. You will review Medicare drug appeals (Part D and B) and collaborate with clinicians to support value-based care within Humana policies. The position emphasizes regulatory compliance and continuous learning of Medicare requirements.

Responsibilities include computer-based review of complex appeals and coordination with internal resources. Some travel to Humana offices may be required.

Competenze

• MD or DO degree with unrestricted license.
• Board certification in a related field preferred.
• Strong communication and analytic abilities.
• Credentialing and quality-management experience helpful.

Mansioni

• Conduct reviews of Medicare drug appeals (Part D and B).
• Collaborate with clinicians to support value-based care.
• Comply with Medicare and Humana policies and regulations.
• Operate with ongoing learning of Part D and MA requirements.

Conoscenze

Communication

Analytical skills

Team collaboration

Credentialing experience

Formazione

MD/DO degree

Medical license (unrestricted)

Board Certification

No sanctions on record

Descrizione del lavoro

Humana, Inc. seeks a Medical Director for a part-time, seasonal, non-benefitted hourly role. You will review Medicare drug appeals (Part D and B) and collaborate with clinicians to support value-based care within Humana policies. The position emphasizes regulatory compliance and continuous learning of Medicare requirements.

Responsibilities include computer-based review of complex appeals and coordination with internal resources. Some travel to Humana offices may be required.