Humana·13 days ago
13 days ago
Physical Health Medical Director
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What you'll do
- lead Medicaid care strategy and operations
- oversee clinical case reviews
- ensure regulatory compliance
- collaborate with healthcare teams
What they're looking for
- board certification in abms recognized specialty
- medicaid licensure (in, oh, ky, va, wi, il)
- experience in Medicaid and clinical management
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
We are currently hiring a Physical Health Medical Director to lead Medicaid care strategy and operations. Oversee clinical case reviews, ensure regulatory compliance, and collaborate with healthcare teams. Ideal for board-certified physicians with experience in Medicaid and clinical management.
Skills
- medicaid care strategy
- board certification in abms recognized specialty
- medicaid licensure (in, oh, ky, va, wi, il)
- utilization management review
- case management
- clinical documentation review
- medical necessity determination
- medicaid policy compliance
- cms policy compliance
- ncqa accreditation process
- cgx
- mhk
- peer-to-peer communication
- conflict resolution
- value-based care
- population health management
- care management
- stakeholder collaboration
- physician consultation
- cross-coverage planning
Company
Humana
Nationwide, United States of America
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