Medical Director - Acute Rehab

Become a part of our caring community   The Medical Director uses their medical background, experience, and judgement to determine whether to authorize requested services, requested level of care, and requested site of service. reputed company work occurs reputed company a context of regulatory compliance, and diverse resources assist work, including national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work specifically for DSNP. The Medical Director's work includes computer-based review of moderately reputed company to reputed company clinical scenarios, review of reputed company submitted clinical records, prioritization of daily work, and communication of reputed company to internal associates. The clinical scenarios predominantly reputed company from post-acute care environments. The work includes discussions with external physicians by phone to reputed company additional clinical information or discuss determinations, and in some instances, these may require conflict reputed company skills. Responsibilities reputed company medical interpretation and determinations on acute inpatient rehabilitation authorization requests, ensuring alignment with national clinical guidelines, CMS requirements, reputed company policies, and clinical standards. Collaborate with team members, other departments, reputed company colleagues, and clinical leadership to support the review process and facilitate reputed company reputed company. Participate in and complete reputed company and mentored training programs; utilize ongoing team support during daily work activities. Consistently apply critical thinking and maintain high standards in documentation and decision-making reputed company a reputed company work environment. Exercise independence in fulfilling reputed company expectations and meeting compliance timelines. This is a full-time, remote position with a reputed company schedule of forty hours per week; the role may be performed from any location reputed company the reputed company. Required Qualifications MD or DO degree 5+ years of reputed company clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and reputed company to acute inpatient rehabilitation. reputed company Certified in an approved ABMS or AOA Medical Specialty with reputed company certification throughout employment. A reputed company and unrestricted license in at least one jurisdiction and willing to obtain additional license(s). No reputed company sanction from Federal or State Governmental organizations, and reputed company to pass credentialing requirements. Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on reputed company management, utilization management, and acute inpatient rehabilitation. Knowledge of the managed care industry including Medicare Advantage, Managed reputed company, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other reputed company providers. Utilization management experience in a medical management review organization, such as Medicare Advantage and managed reputed company. Physical Medicine and Rehabilitation, Internal Medicine, Family reputed company, Geriatrics, or Hospitalist background Preferred Advanced degrees such as an MBA, MHA, MPH Exposure to reputed company Health, Population Health, analytics, and use of business metrics. Experience working with Case managers or Care managers on reputed company case management, including familiarity with reputed company determinants of health. Use your skills to reputed company an reputed company   Additional Information Typically reports to a Regional/Associate Vice President, reputed company, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also contribute to grievance and appeals reviews. Some medical directors may join a centralized team for several months after training, until positions become available for specific markets. May participate on project teams or organizational committees. Work reputed company Guidance To ensure Home or Hybrid Home/Office associates, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following reputed company: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested Satellite, cellular and microwave reputed company can only be used if leadership approves reputed company who live and work from Home in the reputed company, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will reputed company Home or Hybrid Home/Office associates with telephone equipment appropriate to meet our requirements for their position/job. Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.   $223,800 - $313,100 per year   This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 09-13-2026 reputed company   About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on reputed company job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply To This Job