Remote Inpatient Utilization Medical Director

Humana Inc; Lincoln (NE); Remote; USD 224,000 - 313,000; Full time

Benefits offered by this job

Bonus eligibility

Competitive benefits

Job summary

Humana Inc. is seeking a Medical Director to perform expert inpatient medical necessity reviews and contribute to high-quality utilization management.

The role emphasizes structured decision-making, collaboration with a multidisciplinary team, and adherence to national guidelines and CMS rules. Remote position with occasional travel; standard hours Monday–Friday 8am–5pm local time and participation in a bonus incentive plan.

Qualifications

• MD or DO.
• 5+ years post-residency clinical experience.
• Active, unrestricted medical license in at least one state.
• Board Certification in AOABPS or ABMS-recognized specialty.
• Meets credentialing requirements; no sanctions.
• Strong analytical, communication, and documentation skills.
• Able to work in a structured, multidisciplinary team.

Responsibilities

• Conduct inpatient medical necessity reviews promptly and in accordance with regulatory requirements.
• Uphold excellence in productivity, accuracy, quality, and timely completion of assigned tasks.
• Communicate review outcomes clearly and professionally in both verbal and written formats.
• Demonstrate flexibility and adaptability to changing workflows, tools, and utilization management procedures.

Skills

Analytical skills

Communication skills

Documentation skills

Team collaboration

Education

MD or DO

Board Certification (AOABPS/ABMS)

Active medical license in at least one state

Job description

Humana Inc. is seeking a Medical Director to perform expert inpatient medical necessity reviews and contribute to high-quality utilization management.

The role emphasizes structured decision-making, collaboration with a multidisciplinary team, and adherence to national guidelines and CMS rules. Remote position with occasional travel; standard hours Monday–Friday 8am–5pm local time and participation in a bonus incentive plan.