Medical Director - Mid West Region - Remote

Overview

The Medical Director actively uses their medical background, experience, and judgement to make determinations regarding requested services and level of care, ensuring compliance with regulations and guidelines.

In Short

• Actively review medical records and clinical scenarios.
• Engage in discussions with external providers for additional information.
• Collaborate with team members and other departments.
• Support Humana values in all activities.
• Conduct Utilization Management for assigned populations.
• Participate in educational activities and create content for training.
• Identify operational improvements in medical management.
• Participate in call rotation.
• Travel occasionally to Humana's offices for training or meetings.
• Work in a structured environment with minimal direction.

Requirements

• MD or DO degree required.
• 5+ years of clinical patient care experience.
• Current and unrestricted medical license.
• Excellent verbal and written communication skills.
• Experience with quality management and utilization management.
• Knowledge of managed care and Medicare Advantage.
• Analytical and interpretation skills.
• Ability to thrive in a fast-paced environment.
• Commitment to innovation and technology use.
• Experience in hospital-based clinical practice preferred.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off including holidays and volunteer time.
• Short-term and long-term disability.
• Life insurance and additional opportunities.