Remote Medical Director: Outpatient & Value-Based Care

Humana Inc. is seeking a Medical Director for National Outpatient Medicare to review preauthorization requests for complex outpatient cases.

You will apply clinical judgment to determine coverage, level of care, and site of service, using CMS guidelines and Humana policies. You will collaborate with physicians, internal teams, and regional leaders to support value-based care, population health, and improved health outcomes, while ensuring compliance and high-quality utilization management