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Medical Director Lead

1 week ago


Charleston, West Virginia, United States Humana Full time
Job Summary

As a Medical Director at Humana, you will have the opportunity to apply your medical expertise to drive informed decision-making and support the delivery of high-quality care to our members.

Key Responsibilities Include:
  • Conducting thorough reviews of medical records to determine the appropriateness of care and services.
  • Utilizing clinical judgment and analysis to inform decisions regarding service authorization and level of care.
  • Collaborating with internal stakeholders, including case managers, care managers, and other healthcare professionals, to ensure effective communication and coordination of care.

Skills and Qualifications

We are seeking an experienced Medical Director who possesses a strong background in medicine, with a focus on direct patient care experience, preferably in an inpatient environment or related to the care of Medicare-type populations. The ideal candidate will also possess excellent verbal and written communication skills, analytical and interpretation abilities, and prior experience participating in teams focused on quality management, utilization management, case management, discharge planning, and/or home health or post-acute services.