Medical Director – National IP UM Team
Humana
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $223,800 - $313,100 per year
Job Level
Lead
About the role
- Actively use medical background and experience to make determinations regarding authorization of services
- Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services
- Maintain accountability for productivity, quality, and compliance metrics
- Communicate determinations clearly both verbally and in writing
- Participate in rotational weekend work and occasional holiday responsibilities
- Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices
Requirements
- MD or DO degree
- 5+ years of direct clinical patient care experience post residency or fellowship, preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age)
- 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 license, if required
- No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
- Excellent verbal and written communication skills
- Evidence of analytic and interpretation skills, with prior experience working in a team environment
Benefits
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical necessity reviewsauthorization of servicesclinical patient careinpatient careutilization management
Soft skills
communication skillsadaptabilityanalytical skillsteamworkaccountability
Certifications
MD degreeDO degreeBoard Certificationmedical specialty license