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Remote Medical Director: Utilization & Care Leadership

Remote / Online - Candidates ideally in
Salem, Marion County, Oregon, 97308, USA
Listing for: Humana Inc
Remote/Work from Home position
Listed on 2026-08-31
Job specializations:
  • Healthcare
    Healthcare Consultant, Healthcare Management
Salary/Wage Range or Industry Benchmark: 224000 - 313000 USD Yearly USD 224000.00 313000.00 YEAR
Job Description & How to Apply Below

Humana, Inc. seeks a Medical Director to review health claims and clinical data, determine medical necessity, and authorize services across inpatient and post-acute settings.

You will work with internal teams to ensure compliance with national guidelines, CMS policies, and Humana contracts while applying Medicare/Medicare Advantage requirements. Remote in the United States, with responsibilities including peer discussions with external physicians, prioritizing reviews, and contributing to care

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