| Job Summary
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Company Job ID
15342954.9559638 |
Job Title
Medical Director, Senior Segment
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Company:
Humana
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Location
US - UT, Sandy, 84070
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AJE Reference Number
525135218
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Job Start/End Date
not provided
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Job Type
Regular
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Job Classification
Full Time
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Hours/Week
not provided
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Salary Range
not provided
N/A
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Education
Doctoral Degree
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Required Degree/Formal Training
not provided
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Required Licenses/Certificates
df-aj
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Experience
Mid-Career (2 - 15 years)
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Company Homepage
not provided
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Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.
Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.
Role: Clinical Innovations Medical Director
Assignment: Senior Products
Location: Sandy, UT
Are you a fit?
Do you enjoy defining clinical strategy for a major market area? Do you have a desire to be in a position where you can 'provide guidance to our members related to their health care needs? Does this sound like you? If so, then read on!
Assignment Capsule
As a Clinical Innovations Medical Director you will provide medical leadership and strategy for a regional Health Services Operations with fiscal responsibility for trend management.
Play an active role in the regional medical community.
Ensure participation on market committees that require medical expertise.
Provide support and ensures compliance with all regulatory issues related to utilization management.
Implement quality improvement programs as defined by corporate leadership and CMS.
Responsible for medical interpretation, reviews, and decisions as required for plan administration.
Key Competencies
Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.
Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.
Role Essentials
Current MD license in the state(s) in which you are required to practice
Ability to be licensed in multiple states without restrictions
Advanced experience working in a private medical practice or in a hospital setting.
Role Desirables
Health Plan experience
Previous Medicare/Medicaid Experience a plus
Previous experience leading teams focusing on utilization management, discharge planning and/or home health or rehab
Bilingual is a plus
Reporting Relationships
You will report to a Regional CEO. This area is under the leadership of the SVP & Chief Operating Officer.
Additional Information
A benefit package may or may not be available. Request specific information from the employer.
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