Medical Director

4 weeks ago


Louisville, Kentucky, United States CenterWell Home Health Full time
Job Summary

We are seeking a highly skilled Medical Director to join our team at CenterWell Home Health. As a Medical Director, you will be responsible for providing medical interpretation and determinations on services provided by other healthcare professionals, ensuring they align with national guidelines, CMS requirements, and Humana policies.

Key Responsibilities
  • Provide medical interpretation and determinations on services provided by other healthcare professionals
  • Collaborate with other team members, departments, and Humana colleagues to ensure compliance with regulatory requirements
  • Exercise independence in meeting departmental expectations and meeting compliance timelines
  • Participate in care management and make determinations on services, level of care, and site of service
  • Communicate decisions to internal associates and participate in conflict resolution as needed
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
  • Current and unrestricted license in at least one jurisdiction
  • Excellent verbal and written communication skills
Preferred Qualifications
  • Knowledge of the managed care industry, including Medicare Advantage, Managed Medicaid, and Commercial products
  • Utilization management experience in a medical management review organization
  • Experience with national guidelines, such as MCG or InterQual
About Us

CenterWell Home Health is committed to putting health first for our teammates, customers, and company. We make it easier for the millions of people we serve to achieve their best health, delivering the care and service they need, when they need it.



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