Base: $223,800 - $313,100 py; bonus: eligible for ...
Hybrid
Md or do degree required
5+ years post-residency experience
Active unrestricted medical license
The role involves performing expert clinical reviews of inpatient medical records to assess medical necessity based on CMS regulations and Humana policies
Job Summary
The role involves performing expert clinical reviews of inpatient medical records to assess medical necessity based on CMS regulations and Humana policies.
Physicians will collaborate within a structured team environment to advance the quality of inpatient care through thoughtful medical necessity review.
The position offers standard work hours from Monday to Friday with rotational weekend coverage and includes competitive benefits like medical, dental, vision, and 401(k) plans.
Matching Summary
The role involves performing expert clinical reviews of inpatient medical records to assess medical necessity based on CMS regulations and Humana policies.
Salary
Base: $223,800 - $313,100 per year; Bonus: Eligible for incentive plan based on performance; Benefits: Medical, dental, vision, 401(k), paid time off, disability, life insurance
Skills & Requirements
Must-have
MD or DO degree required
5+ years post-residency experience
Active unrestricted medical license
Board certification in recognized specialty
Inpatient medical necessity review skills
Nice-to-have
Prior utilization management experience
Familiarity with MCG or InterQual guidelines
Experience with Medicare populations
Proficiency with clinical technology platforms
Interest in educational content creation
Key Requirements
MD or DO degree
5 or more years post-residency clinical experience
Active unrestricted medical license in at least one state
Current Board Certification in AOABPS- or ABMS-recognized specialty