Unknown Company is hiring a Medical Director - OneHome

Join Our Compassionate Healthcare Team and Champion Patient Well-being The Medical Director is responsible for interpreting and evaluating healthcare services according to CMS Medicare Guidelines, covering home health, skilled nursing facilities, durable medical equipment, dual Medicare/Medicaid, and Waiver requests. The role involves assessing whether healthcare professional services align with national standards, CMS requirements, organizational policies, clinical benchmarks, and potential contractual obligations. The Medical Director provides expert medical evaluations regarding service appropriateness, ensuring compliance with review protocols, performance standards, and regulatory expectations. Work is supported by comprehensive resources including clinical guidelines, CMS policies, reference materials, internal educational sessions, and specialized expertise. Medical Directors will develop comprehensive understanding of Medicare and Medicare Advantage frameworks, translating theoretical knowledge into practical implementation. Use Your Expertise to Drive Meaningful Change Required Qualifications - Medical Doctorate (MD or DO) - Active board certification through recognized ABMS or AOABPS Medical Specialty - Current unrestricted medical license in at least one jurisdiction - Willingness to obtain additional state licenses as needed - Minimum 5 years direct clinical patient care post-residency/fellowship - Clear record without governmental sanctions - Ability to meet credentialing requirements - Superior verbal and written communication skills - Analytical and interpretative capabilities - Commitment to educational engagement and content development Preferred Qualifications - Inpatient or Medicare population care experience - Specialties including Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care - Proficiency in dynamic, fast-paced environments - Innovation-focused mindset - Dedication to consistent outcomes and consumer experiences - Familiarity with national clinical guidelines Responsibilities include conducting clinical case reviews for Medicare population members, reporting to Lead Medical Director, identifying operational improvements, participating in call rotations, developing collaborative partnerships, supporting Home Solutions, and executing additional assigned tasks. Travel: Remote position with occasional in-person training/meetings required. Weekly Hours: 40 Compensation Range: $223,800 - $313,100 annually Bonus incentive plan available based on performance Comprehensive Benefits Package: - Medical, dental, vision coverage - 401(k) retirement plan - Paid time off - Holiday allowances - Volunteer time - Parental leave - Disability insurance - Life insurance Application Deadline: 02-28-2026 About Humana: A healthcare organization committed to improving lives through integrated insurance and healthcare services, focusing on Medicare, Medicaid, individual, and community wellness. Equal Opportunity Employer: Committed to non-discriminatory hiring practices, valuing diversity and inclusion across all employment dimensions.