Unknown Company is hiring an OneHome - Medical Director - Part Time

Join Our Compassionate Healthcare Team and Champion Wellness Initiatives The Medical Director is responsible for implementing CMS Medicare Guidelines through comprehensive review of home health, SNF, DME, dual Medicare/Medicaid, and Waiver requests. The role involves providing expert medical evaluations to determine whether services delivered by healthcare professionals align with national standards, CMS requirements, organizational policies, clinical benchmarks, and potential contractual obligations. The Medical Director evaluates service appropriateness by healthcare professionals, ensuring strict adherence to review protocols, procedural standards, and performance expectations. Work occurs within a comprehensive regulatory framework, supported by diverse knowledge resources including national clinical guidelines, CMS policy interpretations, clinical reference materials, internal educational sessions, and specialized expertise. Medical Directors will master Medicare and Medicare Advantage protocols, operationalizing intricate knowledge through consistent, systematic professional approaches. Leverage Your Expertise to Drive Meaningful Impact Required Qualifications - MD or DO degree - Current and continuous board certification through approved ABMS or AOABPS Medical Specialty - Active, unrestricted medical license in minimum one jurisdiction with willingness to obtain additional state licenses - 5+ years direct clinical patient care experience post residency/fellowship - No federal or state governmental sanctions - Ability to successfully complete credentialing requirements - Superior verbal and written communication with robust analytical capabilities - Active participation in educational initiatives, including conference attendance and content development Preferred Qualifications - Extensive experience in inpatient settings serving Medicare-eligible populations - Specialties including Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care - Demonstrated adaptability in dynamic professional environments - Commitment to innovative organizational culture - Passionate about delivering consistent outcomes and exceptional consumer experiences - Comprehensive understanding of national guidelines like NCD/LCD, MCG® or InterQual Primary Responsibilities - Conduct clinical case reviews for Medicare population requests - Report findings to Lead Medical Director - Identify operational improvements within medical management - Participate in weekend call rotation - Develop collaborative interdepartmental partnerships - Support Home Solutions as needed - Execute additional assignments from managing Medical Director Travel: Remote position with occasional office visits for training/meetings Scheduled Weekly Hours: 1 Compensation Range: $223,800 - $313,100 annually Benefits include paid time off, 401(k) retirement plan, employee assistance program, business travel and accident coverage Application Deadline: 01-31-2026 About Humana Committed to prioritizing health for teammates, customers, and organizational ecosystem. Delivering comprehensive care through insurance and healthcare services. Equal Opportunity Employer Humana maintains non-discriminatory employment practices across all dimensions, emphasizing inclusion and opportunity for all qualified individuals.