Job Details

Humana Inc. seeks a Corporate Medical Director to provide medical interpretation and strategic leadership for OneHome initiatives.

You will review health claims and clinical requests to determine medical necessity and ensure compliance with CMS, Medicaid, and Humana policies, guiding home care services decisions. You will advise executives, act as a clinical SME on home-based and post-acute care, and drive policies and workflows to improve review quality, performance, and care coordination