Medical Director - Acute Rehab
Job
Humana
Boise, ID (In Person)
Full-Time
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Job Description
Medical Director - Acute Rehab
at Humana in Boise, Idaho, United States
Job Description
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. All work occurs within 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 complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, and communication of decisions to internal associates. The clinical scenarios predominantly arise from post-acute care environments. The work includes discussions with external physicians by phone to gather additional clinical information or discuss determinations, and in some instances, these may require conflict resolution skills.
Responsibilities
+ Provide medical interpretation and determinations on acute inpatient rehabilitation authorization requests, ensuring alignment with national clinical guidelines, CMS requirements, Humana policies, and clinical standards.
+ Collaborate with team members, other departments, Humana colleagues, and clinical leadership to support the review process and facilitate quality outcomes.
+ Participate in and complete structured 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 within a structured work environment.
+ Exercise independence in fulfilling enterprise expectations and meeting compliance timelines.
+ This is a full-time, remote position with a standard schedule of forty hours per week; the role may be performed from any location within the United States.
Required Qualifications
+ MD or DO degree
+ 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and related to acute inpatient rehabilitation.
+ Board Certified in an approved ABMS or AOA Medical Specialty with continued certification throughout employment.
+ A current a
Job Posting:
JC291845229
Posted On:
May 15, 2026Updated On:
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