[Remote] OneHome - Medical Director - Part Time at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Part TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Skills

Key technologies and capabilities for this role

Medical DirectorCMS Medicare GuidanceHome HealthSNFDMEMedicare/MedicaidWaiver requestsClinical guidelinesMedicare AdvantageMDDOBoard CertificationMedical SpecialtyLicenseClinical patient careCommunication skillsAnalytic skillsInterpretive skills

Questions & Answers

Common questions about this position

Is this a full-time or part-time position?

This is a part-time position.

What are the required qualifications for the Medical Director role?

Required qualifications include an MD or DO degree, current board certification in an approved ABMS Medical Specialty, a current unrestricted license in at least one jurisdiction (willing to obtain more as required), 5+ years of direct clinical patient care post-residency, no sanctions, ability to pass credentialing, excellent communication and analytic skills, and participation in educational activities.

What salary or compensation is offered for this role?

This information is not specified in the job description.

What is the company culture like at Humana for this role?

The role involves a structured environment with expectations for consistency in thinking, authorship, meeting departmental expectations, and compliance timelines, and preferred candidates show commitment to a culture of innovation, consistency in outcomes, consumer experiences, and a highly engaged team culture.

What makes a strong candidate for this Medical Director position?

Strong candidates will have preferred experience in inpatient care or with Medicare populations, board certification in fields like Internal Medicine, Family Practice, Geriatrics, or similar, ability to thrive in a dynamic fast-paced environment, and knowledge of national guidelines such as NCD/LCD, MCG®, or InterQual.

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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