Director of Clinical Operations

1 week ago


Raleigh, North Carolina, United States Humana Full time
Job Description: Medical Director

We are seeking a highly experienced Medical Director to join our team at Humana. In this role, you will be responsible for providing medical interpretation and decision-making skills in compliance with review policies, procedures, and performance standards.

The ideal candidate should have excellent analytical and problem-solving skills, as well as strong communication and interpersonal skills. You will work closely with our team to develop strategies that improve patient outcomes and reduce healthcare costs.

Key Responsibilities:

  1. Provide medical interpretation and determinations regarding the appropriateness of services provided by other healthcare professionals.
  2. Support and collaborate with other team members, departments, and stakeholders to achieve shared goals.
  3. Analyze complex data and make informed decisions about healthcare services.
  4. Develop and implement strategies to improve patient outcomes and reduce healthcare costs.

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.
  • No current sanction from Federal or State Governmental organizations.
  • Excellent verbal and written communication skills.

Benefits:

  • Competitive salary and bonus opportunities.
  • Comprehensive benefits package, including medical, dental, and vision insurance.
  • 401(k) retirement savings plan.
  • Paid time off and holidays.
  • Professional development opportunities.

Schedule:

This is a full-time position, requiring 40 hours per week. The scheduled weekly hours may vary based on business needs.



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