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Medical Director – Claims Management
Location
United States
Posted
149 days ago
Salary
$223.8K - $313.1K / year
Seniority
Lead
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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