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Medical Director-Payment Integrity @ Humana

Remote, NationwideRemoteFull-time
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About this role

Become part of our team as a Medical Director, where you will use your medical expertise to determine the appropriateness of services at the inpatient level, ensuring regulatory compliance. You will review clinical records and collaborate with colleagues, making impactful decisions. Ideal candidates have significant clinical experience and a strong understanding of Medicare requirements.. Category: Physician

Skills

board certification (abms medical specialty)md or do degreeinpatient careclinical documentation reviewmedicare requirementsmedicaid requirementscms requirementsclinical scenario interpretationutilization managementcase managementdispute resolutiongrievance and appeals reviewpeer-to-peer communicationquality managementdischarge planning

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