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Director of Medical Operations

1 week ago


Hartford, Connecticut, United States Humana Full time
Medical Director Job Description

Humana is seeking a highly qualified Medical Director to lead our medical operations in Florida. As a Medical Director, you will be responsible for overseeing the utilization management of care received by our members in assigned markets, member populations, or condition types.

Key qualifications for this role include a 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, and a current and unrestricted license in at least one jurisdiction.

Responsibilities:

  • Conduct utilization management reviews of clinical scenarios, including inpatient or post-acute care environments.
  • Communicate decisions to internal associates and participate in care management initiatives.
  • Collaborate with external physicians, physician groups, facilities, or community groups to support regional market priorities.