Individual Product Medical Director – Waukesha

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.

Role: Clinical Innovations Medical Director
Assignment: HumanaOne
Location: Waukesha, WI

Are you a fit?
Do you enjoy defining clinical strategy for a major market area? Do you have a desire to be in a position where you can 'provide guidance to our members related to their health care needs? Does this sound like you? If so, then read on!
Assignment Capsule
As a Clinical Innovations Medical Director you will provide medical leadership and strategy for a regional Health Services Operations with fiscal responsibility for trend management.

• Play an active role in the regional medical community.
  
• Ensure participation on market committees that require medical expertise.
  
• Provide support and ensures compliance with all regulatory issues related to utilization management.
  
• Implement quality improvement programs as defined by corporate leadership and CMS.
  
• Responsible for medical interpretation, reviews, and decisions as required for plan administration.

Key Competencies

• Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
  
• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
  
• Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.
  
• Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
  
• Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

Role Essentials

• Current MD license in the state(s) in which you are required to practice
  
• Ability to be licensed in multiple states without restrictions
  

• Advanced experience working in a private medical practice or in a hospital setting.

Role Desirables

• Health Plan experience
  
• Previous Medicare/Medicaid Experience a plus
  
• Previous experience leading teams focusing on utilization management, discharge planning and/or home health or rehab
  
• Bilingual is a plus

Reporting Relationships
You will report to a Regional CEO. This area is under the leadership of the SVP & Chief Operating Officer.

Apply Here