Part-Time Medical Director – Remote, Value-Based Care

Humana, Inc.; Cheyenne (WY); Remote; USD 224,000 - 313,000; Part time

Benefits offered by this job

No benefits (part-time/seasonal)

Job summary

Humana, Inc. is seeking a Medical Director for a part-time, seasonal, remote role in the United States. The candidate will review Medicare drug appeals (Part D and B) using Medicare rules, Humana policies, and clinical literature to ensure appropriate coverage decisions.

Requirements include MD/DO, unrestricted license, board certification in a relevant specialty, and strong communication and analytic skills. Travel may be required for occasional training or meetings.

Qualifications

• MD or DO degree.
• Current and unrestricted license in at least one jurisdiction; willing to obtain additional license, if required.
• Board Certification with preference for Internal Medicine, Family Medicine, Emergency Medicine or Physical Medicine and Rehabilitation.
• No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
• Excellent verbal and written communication skills.
• Evidence of analytic and interpretation skills, with prior experience in quality or utilization management.

Responsibilities

• Review Medicare drug appeals (Part D and B) for coverage decisions.
• Collaborate with clinicians and staff to provide value-based care in accordance with Medicare and Humana policy.
• Operate within regulatory compliance and Humana policies with supported resources.

Skills

Communication skills

Analytic skills

Education

MD/DO

Unrestricted license

Board Certification (IM/FM/EM/PM&R)

Job description

Humana, Inc. is seeking a Medical Director for a part-time, seasonal, remote role in the United States. The candidate will review Medicare drug appeals (Part D and B) using Medicare rules, Humana policies, and clinical literature to ensure appropriate coverage decisions.

Requirements include MD/DO, unrestricted license, board certification in a relevant specialty, and strong communication and analytic skills. Travel may be required for occasional training or meetings.