Remote Medical Director: Medicare Appeals & Value-Based Care
Humana
Humana Inc. is seeking a Medical Director to provide clinical leadership in reviewing Medicare drug appeals (Part D & B) and to ensure decisions align with Medicare rules, Humana policy, and medical necessity.
The role involves computer-based reviews, peer discussions with prescribers, and support for CMS audits while collaborating with clinicians to deliver optimal value-based care. A license, Board Certification, and strong analytic skills are essential; occasional travel to Humana offices may
#J-18808-LjbffrVacancy posted 3 days ago
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