Remote Medical Director: Medicare/Medicaid Compliance Lead

Humana Inc. is seeking a Medical Director for a remote role to review and adjudicate medical necessity for Medicare and Medicaid members in alignment with CMS guidance and Humana policies.

The role emphasizes applying clinical guidelines, regulatory standards, and timely decisions across Home Health, SNF, DME, and related services. The position requires board certification, state licensure, and 5 years of direct clinical care post-residency, with travel to Humana offices for certain trainings.