Director Physician Leadership

Profile

Description

The Director, Physician Leadership relies on medical background and reviews health claims. The Director, Physician Leadership requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

Responsibilities

The Director, Physician Leadership provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

Required Qualifications

Master's Degree

5 or more years of management experience

A current and unrestricted license in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment

MD or DO degree

Board Certified in an approved ABMS Medical Specialty

Excellent communication skills

5 years of established clinical experience

Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products

Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.

Internal Medicine, Family Practice, Geriatrics, OBGYN, Hospitalist clinical specialists.

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com