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Medical Director

1 week ago


Providence, Rhode Island, United States Humana Full time
The Medical Director role at Humana offers a unique opportunity to combine clinical expertise with business acumen to drive improved health outcomes and reduced healthcare costs. As a key member of our care management team, you will be responsible for reviewing and authorizing medical services, developing clinical policies, and collaborating with healthcare providers to improve patient care.

With a strong focus on quality and safety, Humana is dedicated to delivering exceptional patient experiences and outcomes. We believe that every individual deserves access to high-quality healthcare, regardless of their background or circumstances. As a Medical Director at Humana, you will play a critical role in helping us achieve this vision by making informed decisions about patient care and contributing to the development of clinical policies and procedures.

We are seeking a highly motivated and experienced healthcare professional to join our team as a Medical Director. The ideal candidate will have a strong clinical background, excellent communication skills, and a proven ability to work collaboratively with others. If you are passionate about improving health outcomes and working in a dynamic and supportive environment, we encourage you to apply for this role.

Responsibilities

* Review and authorize medical services to ensure they meet Humana's clinical guidelines and regulatory requirements
* Develop and implement clinical policies and procedures to promote high-quality care
* Collaborate with healthcare providers to improve patient outcomes and reduce healthcare costs
* Stay up-to-date on the latest clinical guidelines and best practices
* Make informed decisions about patient care based on your knowledge and expertise

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 and willingness to obtain additional license if required
* Excellent verbal and written communication skills
* Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation

Benefits

Humana offers a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) retirement savings plan, time off (including paid time off, company holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. We also provide opportunities for professional growth and development, including training programs, mentorship, and education assistance.