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Medical Director - Annapolis - Humana

Description
Medical Director
Put Health First with Humana
We are seeking a Medical Director to lead our medical review team and ensure high-quality care for our members.
The Medical Director will rely on their medical background and experience to review health claims, authorize services, and make determinations on the level of care and site of service. They will work closely with diverse resources, including national clinical guidelines, CMS policies, and internal teaching conferences.
The ideal candidate will have a strong analytical and interpretation skillset, with prior experience in teams focusing on quality management, utilization management, case management, and discharge planning. They should also be knowledgeable about managed care industry principles and Medicare Advantage requirements.
Responsibilities:
Requirements:
Preferred Qualifications:
At Humana, we offer competitive benefits, a structured environment, and opportunities for growth and development. If you are passionate about putting health first and making a meaningful impact, apply now!
Work Schedule: Monday - Friday, with some weekends required.
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