Remote Medical Director: Acute Rehab & Utilization

Humana Inc; Topeka (KS); À distance; USD 224 000 - 313 000; Plein temps

Résumé du poste

Humana Inc. is seeking a Medical Director to authorize services, determine level of care, and site of service per CMS and Humana policies. The role requires clinical judgment, strong collaboration, and adherence to regulatory standards, with a focus on DSNP.

The position is fully remote, 40 hours weekly, and may be performed from any location within the United States. You'll engage with external physicians and internal teams to ensure quality outcomes and compliant practices.

Qualifications

• MD or DO degree required.
• 5+ years of direct clinical patient care post residency/fellowship.
• Board Certified with continued certification.
• Active license in at least one jurisdiction.
• No sanctions from Federal or State Governmental organizations.
• Experience with utilization management and quality programs.

Responsabilités

• Provide medical interpretation and determinations on authorization requests.
• Collaborate with teams to support review processes and quality outcomes.
• Participate in structured and mentored training programs.
• Maintain high standards in documentation and decision-making.
• Exercise independence to meet compliance timelines.
• Work remotely from anywhere in the United States with a 40-hour week.

Connaissances

Medical training

Analytical skills

Utilization management

Medicare knowledge

Communication skills

Board certification

Formation

MD/DO degree

Board-certified

Description du poste

Humana Inc. is seeking a Medical Director to authorize services, determine level of care, and site of service per CMS and Humana policies. The role requires clinical judgment, strong collaboration, and adherence to regulatory standards, with a focus on DSNP.

The position is fully remote, 40 hours weekly, and may be performed from any location within the United States. You'll engage with external physicians and internal teams to ensure quality outcomes and compliant practices.