Base: $223,800 - $313,100 py; bonus: eligible for ...
Hybrid
Md or do degree required
5+ years direct clinical patient care experience
Current board certification by abms or aoa
CarePlus Health Plans Inc. is seeking a Medical Director for National Op Medicare to oversee clinical reviews and ensure compliance with national guidelines and CMS requirements. The ideal candidate will have significant clinical experience, preferably with Medicare populations, and will be part of a supportive, collaborative environment
Job Summary
The Medical Director provides critical medical interpretations and determinations ensuring services align with national guidelines and CMS requirements.
This role involves reviewing complex clinical scenarios, communicating decisions to internal teams, and collaborating with external physicians to resolve care issues.
Humana offers competitive benefits including medical, dental, vision, 401(k) retirement savings, and paid time off to support whole-person well-being.
Matching Summary
Match Score: 85
CarePlus Health Plans Inc. is seeking a Medical Director for National Op Medicare to oversee clinical reviews and ensure compliance with national guidelines and CMS requirements. The ideal candidate will have significant clinical experience, preferably with Medicare populations, and will be part of a supportive, collaborative environment.
Salary
Base: $223,800 - $313,100 per year; Bonus: Eligible for incentive plan based on performance; Benefits: Medical, dental, vision, 401(k), PTO, and internet stipend for eligible states
Skills & Requirements
Must-have
MD or DO degree required
5+ years direct clinical patient care experience
Current board certification by ABMS or AOA
Unrestricted medical license in at least one jurisdiction