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

Humana; United States; Remote; USD 224,000 - 313,000; Part time

Benefits offered by this job

Flexible hours

Job summary

Humana is seeking a Medical Director for a part-time, seasonal role to review Medicare drug appeals. Requires MD/DO, unrestricted license, and board certification. You will collaborate with clinicians and support staff to ensure value-based care in line with Medicare and Humana policy.

Responsibilities include computer-based reviews of complex appeals and adherence to CMS policies. Travel may be required; this is a non-benefited, hourly position.

Qualifications

• MD or DO degree required.
• Current and unrestricted medical license.
• Board certification in Internal Medicine, Family Medicine, Emergency Medicine or PM&R preferred.

Responsibilities

• Review Medicare drug appeals (Part D and B) using CMS policies and Humana guidelines.
• Collaborate with clinicians and staff to support value-based care for Humana members.
• Conduct computer-based reviews of complex to highly complex appeals and participate in related activities.

Skills

Verbal communication

Written communication

Analytic skills

Team collaboration

Education

MD or DO degree

Unrestricted medical license

Board Certification (Internal/Family/Emergency/PM&R)

Job description

Humana is seeking a Medical Director for a part-time, seasonal role to review Medicare drug appeals. Requires MD/DO, unrestricted license, and board certification. You will collaborate with clinicians and support staff to ensure value-based care in line with Medicare and Humana policy.

Responsibilities include computer-based reviews of complex appeals and adherence to CMS policies. Travel may be required; this is a non-benefited, hourly position.