Remote Inpatient Utilization Medical Director

Humana Inc; Lansing (MI); Remote; USD 224,000 - 313,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k)

Job summary

Humana Inc. is seeking a Medical Director to perform inpatient medical necessity reviews and guide utilization management from a remote setting. The role emphasizes data-driven decision-making and collaboration with a multidisciplinary team in line with CMS guidelines and Humana policies.

The ideal candidate has an MD/DO with 5+ years post-residency, board certification, and licensure flexibility to obtain additional licenses. Competitive salary and comprehensive benefits are included.

Qualifications

• MD or DO credential and active license
• 5+ years post-residency clinical experience
• Board certification in AOABPS or ABMS-recognized specialty
• Willingness to obtain additional licenses as needed
• Strong analytical, communication, and documentation skills

Responsibilities

• Perform inpatient medical necessity reviews per guidelines and Humana policies
• Deliver clear utilization management determinations
• Communicate review outcomes with providers verbally and in writing
• Work within a multidisciplinary team, adapting to workflows
• Maintain productivity, accuracy, and timely task completion

Skills

Analytical skills

Communication

Documentation

Team collaboration

Education

MD or DO

Job description

Humana Inc. is seeking a Medical Director to perform inpatient medical necessity reviews and guide utilization management from a remote setting. The role emphasizes data-driven decision-making and collaboration with a multidisciplinary team in line with CMS guidelines and Humana policies.

The ideal candidate has an MD/DO with 5+ years post-residency, board certification, and licensure flexibility to obtain additional licenses. Competitive salary and comprehensive benefits are included.