Medical Director - Acute Rehab

Job Listing ID:

4493423

Job Title:

Medical Director -

Acute Rehab Application Deadline:

Open Until Filled

Job Location:

Salem

Date Posted:

05/16/2026

Hours Worked Per Week:

Not Provided Shift:

Not Provided Duration of Job:

Either Full or Part Time, more than 6 months You may contact this employer directly. (Obtain the contact information to print or add to your jobs.)

Job Summary:

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 and unrestricted license in at least one jurisdiction and willing to obtain additional license(s). No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, and acute inpatient rehabilitation. Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers. Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid. Physical Medicine and Rehabilitation, Internal Medicine, Family Practice, Geriatrics, or Hospitalist background Preferred Advanced degrees such as an

MBA, MHA, MPH

Exposure to Public Health, Population Health, analytics, and use of business metrics. Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.

Job Classification:

Medical and Health Services Managers Access our statewide or regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. Compensation

Salary:

Not Provided Job Requirements

Experience Required:

 See Job Summary

Education Required:

None

Minimum Age:

N/A Gender:

N/A