Humana
10,000+ employees
Founded 1961
⚕️ Healthcare Insurance
Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
VP, Physician Review, Market Insights
🕒 June 5
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Humana
10,000+ employees
Founded 1961
⚕️ Healthcare Insurance
Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
📋 Description
• Set clinical strategy and lead the Utilization Management organization. • Oversee the integration of medical doctors and registered nurses in UM across Medicaid and Medicare. • Provide leadership in risk management, grievance and appeals, clinical contracting, vendor management, and UM dental review. • Ensure the clinician’s perspective is central to organizational decision-making. • Leverage analytics to inform strategy and performance improvement. • Sponsor the development of clinical talent and leadership pipeline.
🎯 Requirements
• MD/DO • Current Board Certification • Minimum 10 years of combined leadership and/or UM experience • Passion for improving Star Ratings, review consistency, and health outcomes • Deep knowledge of medical, clinical, and behavioral science underpinning UM • Strong interpersonal, leadership, and business acumen • Proven ability to drive cross-functional results and champion clinical perspectives.
🏖️ Benefits
• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options
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