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Director of Medical Operations

1 week ago


Lincoln, Nebraska, United States Humana Full time

About the Position

We are seeking a highly experienced Medical Director to lead our North Central Medicaid Markets team. The ideal candidate will have strong leadership skills, excellent analytical and communication skills, and ability to collaborate with internal teams. As a Medical Director, you will be responsible for overseeing medical interpretation and determinations, ensuring high-quality patient care through effective utilization management.

Responsibilities

  • Oversee medical interpretation and determinations on services provided by other healthcare professionals
  • Lead internal teams, including care managers, case managers, and other departments
  • Ensure high-quality patient care through effective utilization management

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 VA or willingness to obtain by start date
  • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements