Medical Director - OneHome

Job Listing ID:

4490203

Job Title:

Medical Director -

OneHome Application Deadline:

Open Until Filled

Job Location:

Salem

Date Posted:

05/12/2026

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 relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME, dual Medicare/Medicaid requests. The Medical Director reviews and determines whether healthcare services provided by other healthcare professionals align with national guidelines, CMS requirements, Humana policies, clinical standards, and applicable contracts. The Medical Director evaluates the medical necessity of healthcare services, ensuring decisions comply with regulatory and organizational standards. The role requires interpreting clinical guidelines, CMS policies, and Medicare requirements, and applying them consistently. All work at OneHome is conducted within a framework of regulatory compliance. This secures compliance with all requirements set by federal and state laws. Medical Directors review clinical cases for Medicare and Medicaid members, report to the Lead Medical Director, and work within defined timelines and departmental expectations.

Role Responsibilities:

Review clinical cases and determine medical necessity of services for Medicare and Medicaid members Ensure compliance with review policies, procedures, and regulatory standards Apply clinical guidelines, CMS policies, and Medicare/Medicare Advantage/Medicaid requirements Identify opportunities for medical management operational improvements Participate in call rotations, including weekend coverage and after-hours coverage Contribute to an engaged, collaborative team culture that supports organizational excellence Deliver exceptional consumer experiences Support Home Solutions and other activities as assigned by the OneHome leadership Use your skills to make an impact Required Qualifications MD or DO degree Current, active and ongoing board certification from the American Board of Medical Specialties (ABMS) or the American Osteopathic Association Bureau of Osteopathic Specialties (AOABPS). National Board of Physicians & Surgeons (NBPAS) certification is not accepted Current and unrestricted state license in at least one state and willing to obtain other medical licenses, as required, for various states in region of assignment No sanctions from Federal or State Governmental organizations 5 years of direct clinical patient care experience post residency or fellowship The ability to pass credentialing requirements Intermediate to advanced skills utilizing Microsoft Office and Internet navigation Strong verbal and written communication skills, with the ability to analyze information and interpret data clearly and accurately Adaptable and willing to learn new technologies to enhance workflow efficiency Preferred Qualifications Experience in an inpatient and/or outpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age) Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care, Surgery or hospital based clinical specialists

Additional Information Workstyle:

remote work at home

Hours:

Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, call rotations, including weekend coverage and after-hours coverage

Training:

10 weeks of onboarding, no time off and training is in Eastern Standard Time (EST) Work At Home Guidance To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-...

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