Medical Director - Inpatient Review

HumanPanorama

Remote
$223,800 - $313,100 py; bonus incentive plan; medi...
Hybrid
Inpatient medical record review
Medical necessity assessment
Analyze complex hospital cases
Perform expert clinical review of inpatient medical records, assessing medical necessity based on national guidelines, CMS regulations, Humana policies, and recognized clinical standards

Job Summary

  • Perform expert clinical review of inpatient medical records, assessing medical necessity based on national guidelines, CMS regulations, Humana policies, and recognized clinical standards.
  • Collaborate within a structured, team-oriented environment that emphasizes integrity, professionalism, and collegiality.
  • Humana offers competitive benefits that support whole-person well-being, including medical, dental, vision, 401(k) retirement savings plan, and time off.

Matching Summary

Perform expert clinical review of inpatient medical records, assessing medical necessity based on national guidelines, CMS regulations, Humana policies, and recognized clinical standards.

Salary

$223,800 - $313,100 per year; Bonus incentive plan; Medical, dental, vision, 401(k), time off, disability, life insurance

Skills & Requirements

Must-have

  • Inpatient medical record review
  • Medical necessity assessment
  • Analyze complex hospital cases
  • Communicate with external providers
  • Structured team-oriented environment

Nice-to-have

  • Advance quality of inpatient care
  • Impact patient outcomes
  • Process improvement and innovation
  • Contribute to educational content

Key Requirements

  • MD or DO
  • 5+ years post-residency clinical experience
  • Active, unrestricted medical license
  • Board Certification
  • No state or federal sanctions

Work Rights

Not specified

Tailored Resume

Cover Letter