Remote Medical Director - Acute Rehab & Utilization

Humana Inc; Carson City (NV); À distance; USD 224 000 - 313 000; Plein temps

Avantages offerts par ce poste

Remote position

40-hour work week

Résumé du poste

Humana Inc. is seeking a Medical Director to authorize services, determine level of care, and site of service within a remote, nationwide role. The position emphasizes regulatory compliance, CMS guidelines, and efficient utilization management in post-acute care settings.

Qualified candidates will have an MD/DO, 5+ years of relevant clinical experience, board certification, and an unrestricted license. The role offers full-time hours, travel as needed, and involvement with Medicare Advantage and

Qualifications

• MD or DO required and board certified with active license in at least one state.
• Minimum 5 years of direct clinical care post-residency/fellowship, inpatient rehab preferred.
• Experience with utilization management, quality management, and medical policy interpretation.
• Knowledge of Medicare Advantage, managed Medicare/Medicaid, and health plan operations.

Responsabilités

• Provide medical interpretation and determinations on authorization requests for acute inpatient rehabilitation.
• Collaborate with teams to support review processes and achieve quality outcomes.
• Participate in structured training programs and use team support during daily work.
• Maintain high standards in documentation and decision-making within a regulated environment.
• Operate with independence to meet enterprise expectations and timelines.
• This is a full-time, remote role with a 40-hour work week; can be performed from any location in the United States.

Connaissances

MD/DO degree

Clinical patient care

Board Certified

Medical license

Utilization management

Medicare/Medicaid knowledge

Analytical skills

Communication with external physicians

Formation

MD or DO degree

ABMS/AOA board certification

Description du poste

Humana Inc. is seeking a Medical Director to authorize services, determine level of care, and site of service within a remote, nationwide role. The position emphasizes regulatory compliance, CMS guidelines, and efficient utilization management in post-acute care settings.

Qualified candidates will have an MD/DO, 5+ years of relevant clinical experience, board certification, and an unrestricted license. The role offers full-time hours, travel as needed, and involvement with Medicare Advantage and