Medical Director - Nat'l IP UM Team
Humana(3 months ago)
About this role
The Medical Director at Humana utilizes their medical expertise and judgment to determine the authorization of healthcare services, ensuring compliance with regulations and clinical guidelines. This role involves reviewing medical records, synthesizing complex clinical scenarios, and engaging with external providers to gather necessary information and communicate determinations.
Required Skills
- Medical Review
- Clinical Guidelines
- Decision Making
- Team Collaboration
- Analytical Skills
Qualifications
- MD or DO degree
- 5+ years clinical experience
- Board Certification
- Current medical license
About Humana
humana.comExplore Medicare plans and health insurance coverage to fit your lifestyle. Turning 65 or recently qualified? Sign up for Medicare coverage! Start with healthy, start with Humana.
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