Lead Medical Director - OneHome

Employment Type

Full time

About the Role

Become a part of our caring community and help us put health first. The Lead Medical Director manages the physician review of health requests amongst a wide array of OneHome business. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s).

The Lead Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.

Use your skills to make an impact.

Required Qualifications

• MD or DO degree
• Current and ongoing board certification in an approved ABMS Medical Specialty
• A current and unrestricted license in at least one jurisdiction and willing to obtain additional licenses, as required, for various states in region of assignment
• 5+ years of direct clinical patient care experience post-residency or fellowship
• No current sanction from Federal or State Governmental organizations
• The ability to pass credentialing requirements
• Excellent verbal and written communication skills with analytic and interpretative skills from prior experience focusing on quality, utilization, and/or case management
• Knowledge and experience with national guidelines such as NCD/LCD, MCG® or InterQual

Other Activities

• Other activities as assigned by the Vice President or Director of Physician Leadership.

Additional Information

The Lead Medical Director may also lead specific functional areas in addition to leading a team of Medical Directors. The role reports to the Director of Physician Leadership.

Other Duties

• Maintain medical director schedule (PTO, weekend coverage, etc.)
• Develop collaborative relationships with key partners within the Medicare Line of Business, including with internal team associates and leadership.
• Manage regular meetings with various company participants.
• Foster development of medical directors.

Preferred Qualifications

• Demonstrated experience in operations and performance management.
• Experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age) such as Internal Medicine, Family Practice, Geriatrics, or hospital based clinical specialties.
• Two or more years of management experience leading teams in dynamic environments
• Commitment to a culture of innovation, diversity, equity, and inclusion.
• Passionate about contributing to an organization’s focus on consistency in outcomes, consumer experiences and a highly engaged team culture

Travel

• While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

$270,800 - $378,800 per year

This compensation range reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term