Medical Director, Midwest Commercial Markets – Cincinnati

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.

Medical Director, Clinical Review

Putting the "Guide" in Guidance...

When it comes to our members, guidance matters. The important work of our Medical Directors directly impacts our members, sometimes during the most vulnerable moments of their lives. Whether evaluating new technology, devices, pharmaceuticals or healthcare providers, it is the passion and commitment of the Humana medical director team enabling Humana's vision of becoming the most trusted name in healthcare solutions.

Humana is looking for a Cincinnati-based, high-energy physician with solid clinical experience, a passion for evidenced-based medicine, who enjoys innovation. This Medical Director role begins with a primary focus on Clinical Review.

This role carries with it important leadership opportunities within the company. You will participate in Humana Market meetings, lending your expertise, experience and leadership as it relates to important decisions affecting the business. You will be instrumental in driving how we develop and manage programs, centered on continuously evaluating and improving our clinical model and how we participate in the delivery of health benefits solutions.

Medical Director key contributions:
-Using your clinical expertise to manage the clinical model, providing medical interpretation and decisions as required.
-Participating in committees (e.g. quality, credentialing, pharmacy and therapeutics, technology assessment, etc.) which require medical expertise and are required either by regulation, accreditation and/or local market conditions.
-Interfacing with other clinical leadership which includes our staff of Regional Medical Directors and market-based physicians.

Our chief requirements:
-MD or DO degree
-The clinical review activities of this role require an active, unrestricted medical license.
-Board Certification: Primary Care, Internal Medicine, Pathology, GI, or Cardiology a plus.
-Five or more years clinical experience.
-Three or more years medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
-A current and unrestricted Physician License in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment (can be hired in advance of licensure if meets qualifications for licensure in required jurisdictions.)
-Process-oriented, evidence-based and scientifically-inclined, consistent, enjoys being a part of a team, thoughtful and has a thirst for continuous education and development.

Apply Here