Remote Medical Director: Medicare Utilization & Care

Job description

Humana Inc. is seeking a Medical Director to adjudicate inpatient requests, review clinical records, and ensure compliance with Medicare/Medicaid/Medicare Advantage requirements. You will work with a multidisciplinary team, participate in quality initiatives, and may engage in appeals processes. A mentored training period precedes autonomous duties.

This role emphasizes evidence-based decision making, regulatory adherence, and effective communication across Humana care teams.

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Who can apply

Review the original listing for work authorization, qualifications and employer requirements.