Remote Medical Director, Acute Rehab & Utilization

Humana Inc; Lincoln (NE); A distancia; USD 224.000 - 313.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonus incentive plan

Remote work from anywhere in the US

Competitive benefits package

Descripción de la vacante

Humana Inc. is seeking a Medical Director to authorize services and determine levels of care in a remote, full-time capacity. The role emphasizes applying clinical guidelines, CMS requirements, and internal policies within a managed care framework, focused on DSNP programming.

You will review moderately to highly complex clinical cases, interact with external physicians, and participate in training and quality initiatives while meeting strict compliance timelines.

Formación

• MD or DO certification required and active license in at least one state.
• Minimum 5 years of direct clinical patient care post-residency or fellowship.
• Board certified with ongoing certification throughout employment.
• Experience in utilization management and familiarity with Medicare Advantage/Medicaid.
• Knowledge of post-acute rehab settings and managed care processes.

Responsabilidades

• Provide medical interpretation and determinations for rehab authorization requests.
• Collaborate with peers and leadership to ensure quality outcomes.
• Participate in structured training and use team support daily.
• Maintain high standards of documentation and timely decisions.
• Independently meet enterprise expectations and compliance timelines.
• Work remotely full-time with a 40-hour schedule; may travel occasionally.

Conocimientos

MD or DO degree

5+ years clinical care experience

Board Certified

Active license in at least one state

Analytic & interpretation skills

Utilization management experience

Medicare Advantage / Medicaid know-how

Specialty: PM&R / Internal Medicine /+

Educación

MD or DO degree

Descripción del empleo

Humana Inc. is seeking a Medical Director to authorize services and determine levels of care in a remote, full-time capacity. The role emphasizes applying clinical guidelines, CMS requirements, and internal policies within a managed care framework, focused on DSNP programming.

You will review moderately to highly complex clinical cases, interact with external physicians, and participate in training and quality initiatives while meeting strict compliance timelines.