Remote Medical Director, PI & Claims Appeals

Humana, Inc. is seeking a Medical Director to review and authorize services in accordance with national guidelines, CMS requirements, and Humana policies.

The role involves evaluating clinical records, discussing determinations with internal teams, and potentially engaging in care management across inpatient, outpatient, and post-acute settings. The position is remote, with travel as needed, and requires 5+ years of direct clinical patient care post-residency, board certification, and licensure