Remote Medical Director: Acute Rehab & Utilization

Humana Inc; Atlanta (GA); Remote; USD 224,000 - 313,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana Inc. is seeking a Medical Director to authorize services and levels of care within regulatory guidelines and Humana policies. The role emphasizes utilization management and decision communication with internal teams, across post-acute care scenarios.

The position is fully remote, 40 hours weekly, open to candidates nationwide in the United States, with competitive compensation and a bonus plan contingent on performance.

Qualifications

• MD or DO degree.
• 5+ years of direct clinical patient care experience post residency/fellowship.
• Board Certified in an ABMS AO A Medical Specialty with continued certification.
• Current and unrestricted license in at least one jurisdiction.
• No current sanction from Federal or State Governmental organizations; able to pass credentialing.
• Evidence of analytic and interpretation skills with quality/utilization management experience.
• Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid, or other medical management organizations.
• Utilization management experience in a medical management review organization (e.g., Medicare Advantage/Medicaid).
• Background in Physical Medicine and Rehabilitation, Internal Medicine, Family Practice, Geriatrics, or Hospitalist.

Responsibilities

• Provide medical interpretation and determinations on acute inpatient rehabilitation authorization requests.
• Collaborate with team members and leadership to support the review process and quality outcomes.
• Participate in structured and mentored training programs; utilize team support.
• Maintain high standards in documentation and decision-making within a structured work environment.
• Exercise independence in fulfilling enterprise expectations and compliance timelines.
• This is a full-time, remote position with 40 hours per week across the United States.

Skills

Analytic interpretation skills

Utilization management experience

Managed care knowledge

Education

MD/DO degree

Board Certification (ABMS/AOA)

Job description

Humana Inc. is seeking a Medical Director to authorize services and levels of care within regulatory guidelines and Humana policies. The role emphasizes utilization management and decision communication with internal teams, across post-acute care scenarios.

The position is fully remote, 40 hours weekly, open to candidates nationwide in the United States, with competitive compensation and a bonus plan contingent on performance.