Corporate Medical Director

Employment Type: Full-time Location Type: Remote Pay Range: $246,100 - $344,200 per year Scheduled Weekly Hours: 40 Bonus Incentive: Eligible for a bonus incentive plan based on company and/or individual performance.

Position Overview

Become a part of our caring community and help us put health first. The Corporate Medical Director relies on their medical background to review health claims and pre-service appeals. This role addresses problems of diverse scope and complexity, ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness of services provided by other healthcare professionals, ensuring compliance with review policies, procedures, and performance standards. This position also represents Humana at Administrative Law Judge hearings. The role requires exercising independent judgment and decision-making on complex issues related to job duties and tasks, working under minimal supervision and analyzing variable factors to determine the best course of action. The schedule is Monday-Friday with intermittent weekends. Use your skills to make an impact!

Requirements

• MD or DO degree
• A current and unrestricted license in at least one jurisdiction, with willingness to obtain licenses as required for various states in the region of assignment.
• Board Certified in an approved ABMS Medical Specialty.
• Excellent communication skills.
• 5 years of established clinical experience.
• Knowledge of the managed care industry, including Medicare, Medicaid, and/or Commercial products.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

• Medical utilization management experience.
• Experience working with health insurance organizations, hospitals, and other healthcare providers.
• Experience with patient interaction.
• Clinical specialization in Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, PM&R, Anesthesiology, and General Surgery.

Work at Home Guidance

To ensure associates working from home or a hybrid home/office environment can work effectively, the self-provided internet service must meet the following criteria:

• Minimum download speed of 25 Mbps and upload speed of 10 Mbps is recommended.
• Wireless, wired cable, or DSL connection is suggested.
• Satellite, cellular, and microwave connections may be used only if approved by leadership.

Associates who live and work from home in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide necessary telephone equipment. Work must be performed from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel

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

Description of Benefits

Humana, Inc. and its affiliated subsidiaries offer 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, acknowledging that your life extends outside of work. Benefits include:

• 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 disability.
• Life insurance.
• Many other opportunities.