Medical Director – Claims Management
Humana
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $223,800 - $313,100 per year
Job Level
About the role
- Make determinations on requested services and levels of care
- Conduct computer-based reviews of clinical scenarios
- Communicate decisions to internal associates
- Participate in care management meetings and discussions with external physicians
- Ensure all work adheres to regulatory compliance standards
Requirements
- MD or DO degree
- 5+ years of direct clinical patient care experience post residency or fellowship
- Current and ongoing Board Certification in an approved ABMS Medical Specialty
- A current and unrestricted license in at least one jurisdiction
- No current sanction from Federal or State Governmental organizations
- Excellent verbal and written communication skills
- Evidence of analytic and interpretation skills
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 and many other opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical patient careregulatory compliance
Soft Skills
verbal communicationwritten communicationanalytic skillsinterpretation skills
Certifications
MDDOBoard Certificationunrestricted medical license