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Job description
Humana Inc. is seeking a Medical Director to oversee medical necessity determinations for Medicare/Medicaid members, aligning services with CMS guidelines, Humana policies and contracts.
The role ensures regulatory compliance and clinical standards, reporting to the Lead Medical Director within OneHome. Responsibilities include reviewing cases, credentialing, and identifying opportunities for process improvements, with weekend/after-hours rotations and a strong focus on exceptional member
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Worksite address
workfromhome, UT, 84193, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.