The Pharmacy Appeals Lead Medical Director at HumanPanorama is a fully remote position focused on overseeing clinical operations and leading teams within the VSP Physician Program. The ideal candidate will have a strong clinical background, leadership experience, and a member-first approach to healthcare
Job Summary
This leader will oversee the operational and clinical excellence of the VSP Physician Program and serve as a key clinical partner across appeals, audits, and pharmacy operations.
Participate in audit activities as both a researcher and a team oversight lead, ensuring accuracy, readiness, and strong clinical rationale in audit response materials.
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
Matching Summary
Match Score: 85
The Pharmacy Appeals Lead Medical Director at HumanPanorama is a fully remote position focused on overseeing clinical operations and leading teams within the VSP Physician Program. The ideal candidate will have a strong clinical background, leadership experience, and a member-first approach to healthcare.
Salary
Base: $270,800 - $378,800 per year; Bonus/Equity: Eligible for bonus incentive plan; Benefits: Medical, dental, vision, 401(k), time off, disability, life insurance
Skills & Requirements
Must-have
VSP Physician Program oversight
clinical case production
pharmacy operations expertise
audit and compliance participation
member impact focus
Nice-to-have
collaborative team environment
creative problem-solver
continuous improvement mindset
strong member-first perspective
Key Requirements
MD or DO with active, unrestricted medical license
Experience interpreting complex medical and pharmacy evidence
Prior experience in utilization management, appeals, audit, or clinical operations
Demonstrated ability to lead teams, mentor physicians, and manage performance