Part-Time Medicare Drug Appeals Director

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

Job summary

Humana, Inc. invites applications for a part-time, seasonal Medical Director to review Medicare drug appeals (Part D and B). The role is non-benefited and paid hourly, with flexible weekly hours.

Responsibilities include assessing complex to moderately complex cases, aligning with CMS and Humana policies, and supporting value-based care for Humana members. The ideal candidate holds an MD/DO with an unrestricted license, board certification in relevant specialties, and strong communication and

Qualifications

• MD or DO degree and an active, unrestricted license in at least one jurisdiction
• Board certification in a relevant specialty (Internal Medicine, Family Medicine, Emergency Medicine or PM&R)
• Strong verbal and written communication; analytical and data interpretation skills

Responsibilities

• Review Medicare drug appeals (Part D and Part B) using Humana policies and clinical literature
• Collaborate with clinicians and staff to ensure value-based care for Humana members
• Operate within Medicare, Humana policy, and regulatory compliance guidelines

Skills

Verbal communication

Written communication

Analytical skills

Team collaboration

Education

MD or DO degree

Active medical license

Board Certification (Internal Medicine, Family Medicine, Emergency Medicine, or PM&R)

Job description

Humana, Inc. invites applications for a part-time, seasonal Medical Director to review Medicare drug appeals (Part D and B). The role is non-benefited and paid hourly, with flexible weekly hours.

Responsibilities include assessing complex to moderately complex cases, aligning with CMS and Humana policies, and supporting value-based care for Humana members. The ideal candidate holds an MD/DO with an unrestricted license, board certification in relevant specialties, and strong communication and