Remote Medical Director: Inpatient Rehab & Utilization

Humana Inc; Madison (WI); À distance; USD 224 000 - 313 000; Plein temps

Résumé du poste

Humana Inc. seeks a Medical Director for a fully remote role. You will review and authorize services, determine level of care, and ensure compliance with CMS guidelines and Humana policies. The position emphasizes post-acute rehab, utilization management, and collaboration with clinical leadership.

The ideal candidate holds an MD or DO, with 5+ years of patient care, board certification, and an active license. Expect a rigorous, fast-paced environment with remote work and travel as needed.

Qualifications

• MD or DO degree
• 5+ years of direct clinical patient care post residency/fellowship, ideally in inpatient rehab
• Board Certified with ongoing certification
• Current, unrestricted license in at least one jurisdiction
• No federal or state sanctions; able to pass credentialing
• Experience in quality/utilization management
• Knowledge of Medicare Advantage/Medicaid and managed care
• Experience in medical management reviews

Responsabilités

• Provide medical interpretation and determinations on authorization requests, ensuring alignment with guidelines and Humana policies
• Collaborate with team members and clinical leadership to support the review process and outcomes
• Participate in structured, mentored training programs with team support
• Apply critical thinking and maintain high standards in documentation and decisions
• Exercise independence to meet enterprise expectations and timelines

Connaissances

MD/DO

Clinical experience

Board Certification

Medical license

Utilization management

Medicare/Medicaid knowledge

Analytical skills

Formation

MD/DO degree

Board Certification

Active medical license

Description du poste

Humana Inc. seeks a Medical Director for a fully remote role. You will review and authorize services, determine level of care, and ensure compliance with CMS guidelines and Humana policies. The position emphasizes post-acute rehab, utilization management, and collaboration with clinical leadership.

The ideal candidate holds an MD or DO, with 5+ years of patient care, board certification, and an active license. Expect a rigorous, fast-paced environment with remote work and travel as needed.