**Become a part of our caring community and help us put health first**
The Lead Medical Director manages the physician review of health requests amongst a wide array of OneHome business. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s).
The Lead Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.
**Use your skills to make an impact**
**Required Qualifications**
+ Required Qualifications
+ MD or DO degree
+ Current and ongoing board certification in an approved ABMS Medical Specialty
+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional licenses, as required, for various states in region of assignment
+ 5+ years of direct clinical patient care experience post-residency or fellowship
+ No current sanction from Federal or State Governmental organizations
+ The ability to pass credentialing requirements
+ Excellent verbal and written communication skills with analytic and interpretative skills from prior experience focusing on quality, utilization, and/or case management
+ Knowledge and experience with national guidelines such as NCD/LCD, MCG® or InterQual
Other activities as assigned by the Vice President or Director of Physician Leadership.
Additional Information
The Lead Medical Director may also lead specific functional areas in addition to leading a team of Medical Directors. The role reports to the Director of Physician Leadership.
Other duties:
Maintain medical director schedule (PTO, weekend coverage, etc.) Develop collaborative relationships with key partners within the Medicare Line of Business, including with internal team associates and leadership. Manage regular meetings with various company participants. Foster development of medical directors.
Preferred Qualifications
Demonstrated experience in operations and performance management. Experience in an inpatient environment and/or related to care of a Medicare type population (disabled or 65 years of age) such as Internal Medicine, Family Practice, Geriatrics, or hospital based clinical specialties. Two or more years of management experience leading teams in dynamic environments Commitment to a culture of innovation, diversity, equity, and inclusion. Passionate about contributing to an organization's focus on consistency in outcomes, consumer experiences and a highly engaged team culture
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$270,800 - $378,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 08-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our