- UpvoteDownvoteShare Job
- Suggest Revision
Medical Director - Southeast Region - Work from Home at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. This is a full time work from home opportunity.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work. #physiciancareers Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Supports the assigned work with respect to market-wide objectives (e.g. Bold Goal) and community relations as directed. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Applicant is required to work every other weekend. Candidates may live anywhere in the US, but must be willing to work 8:00 am-5:00 pm Eastern time zone. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
A current and unrestricted license in at least one jurisdiction and willing to obtain additional license(s), if required. After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialization + Advanced degree such as an MBA, MHA, or MPH + Exposure to Public Health principles, Population Health, analytics, and use of business metrics.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. May also engage in grievance and appeals reviews.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The clinical scenarios predominantly arise from inpatient or post-acute care environments. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Preferred Qualifications + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
Work from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. The curiosity to learn, the flexibility to adapt and the courage to innovate Additional Information Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business.
Work from homeExpandApply NowActive JobUpdated Today
work at home jobs
FEATURED BLOG POSTS
Why Leadership Is So Important in Your Career
There are plenty of baseball players worldwide, but only a select few will master the sport enough to play in the World Series. Similarly, you’ll meet hundreds of “managers” throughout your professional career. Still, only a few will cement themselves as true leaders in your mind. This is why leadership is important—the most influential leaders leave a mark. They inspire.
Making the Move to Salary Transparency
The salary transparency trend continues. Last year, Colorado passed its Equal Pay Transparency Rules, which required employers to include compensation in job postings, notify employees about promotional opportunities, and record job descriptions and wage records. Soon after, states like Washington, Nevada, Maryland, and Rhode Island followed suit.
Brand Reputation 101
People's initial perception of your organization is also known as your brand reputation. Your brand rep either encourages or discourages people from engaging with your company. This means the way people view your company will affect sales and even recruiting efforts.
Recruiting in a Tight Market
As a recruiter or employer, you know how much the economy affects your recruitment and retention efforts. You aren't just in competition with companies in your industry, but you are also fighting against inflation, recession, unemployment rates, and so much more.
How to Build a Candidate Persona
A candidate persona is a semi-fictional representation of your ideal candidate. Building a candidate persona is one of the best methods employers use to ensure their sourcing, recruiting, and hiring processes are focused. Knowing exactly what you're looking for streamlines everything and helps increase hiring confidence. So here's how to create a candidate persona and how to use it.
How to Get Into The Trades: Step-by-Step Guide
Getting a trade job can be a great career move if you like variety and prefer to learn on the job instead of in an academic setting. A trade job can offer security and be a lucrative career path as the demand for skilled trade workers continues to grow.
How do Good Interviewers Prepare for Interviews?
Just like candidates take the time to research you and your company, you should take the time to prepare for the interview. Preparing for the interview doesn't just reflect well on your employer brand and create a better candidate experience. Preparation also helps prevent bad hiring decisions. Bad hiring decisions are usually a result of poor execution during the hiring process. However, going into an interview fully prepared and ready to evaluate candidates will help avoid bad hires. So, here are 6 interview preparation tips for employers.