Humana

Medical Director - Southeast Medicaid

Humana(1 day ago)

RemoteFull TimeSenior$223,800 - $313,100Healthcare Management
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About this role

Humana is seeking a Medical Director to oversee clinical review processes, make determinations on healthcare services, and support regulatory compliance within managed care. The role involves analyzing complex clinical data, collaborating with healthcare providers, and ensuring quality standards are met across Medicaid and other health programs.

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Required Skills

  • Clinical Review
  • Regulatory Compliance
  • CMS Policies
  • Utilization Management
  • Population Health
  • Medical Interpretation
  • Case Management
  • Clinical Standards
  • Medicaid
  • Post-Acute Care
Humana

About Humana

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