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Medical Director – Claims Management

Medical DirectorMedical DirectorOtherRemoteLeadTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

149 days ago

Salary

$223.8K - $313.1K / year

Seniority

Lead

Professional Certificate5 yrs expEnglish

Job Description

Medical Director – Claims Management

Humana

• Actively uses medical background to make determinations on services and levels of care • Reviews complex clinical scenarios and submitted clinical records • Communicates decisions to internal associates • Discusses cases with external physicians to gather information • May participate in care management and coding practices

Job 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
  • Excellent verbal and written communication skills
  • Evidence of analytic and interpretation skills with prior experience in quality management, utilization management, case management, discharge planning, and/or home health or post-acute services

Benefits

  • Medical, dental and vision benefits
  • 401(k) retirement savings plan
  • Paid time off including personal holidays and volunteer time off
  • Paid parental and caregiver leave
  • Short-term and long-term disability
  • Life insurance

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