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- Tasks: Review health claims and provide medical interpretation to ensure quality care.
- Company: Join a caring community focused on putting health first.
- Benefits: Competitive salary, flexible work options, and opportunities for professional growth.
- Why this job: Make a real impact in healthcare while working with a supportive team.
- Qualifications: MD or DO degree, board certified, and 5 years of clinical experience required.
- Other info: Work from home options available with necessary internet requirements.
The predicted salary is between 36000 - 60000 £ per year.
Become a part of our caring community and help us put health first. The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. Schedule is 8am-5pm Monday-Friday working intermittent weekends based on business needs.
Use your skills to make an impact.
Required Qualifications- MD or DO degree
- A current and unrestricted license in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment
- Board Certified in an approved ABMS Medical Specialty
- Excellent communication skills
- 5 years of established clinical experience post residency
- 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
- Occasional holidays are required
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Although this is a non-leadership role, medical management experience, working with health insurance organizations, hospitals and other healthcare providers, and patient interactions are a nicety
- Internal Medicine, Family Practice, Geriatrics, Hospitalist clinical specialists
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly.
Medical Director, Medicare Grievances in Swindon employer: Humana
Contact Detail:
Humana Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land Medical Director, Medicare Grievances in Swindon
✨Tip Number 1
Network like a pro! Reach out to your connections in the healthcare industry, especially those who might know about opportunities for a Medical Director role. Don’t be shy; ask for informational interviews or advice on how to navigate the application process.
✨Tip Number 2
Prepare for interviews by brushing up on your clinical knowledge and understanding of Medicare grievances. We recommend practising common interview questions and scenarios that might come up, so you can showcase your expertise and decision-making skills.
✨Tip Number 3
Showcase your passion for improving consumer experiences during interviews. Share specific examples from your past roles where you made a positive impact. This will help you stand out as someone who truly cares about the mission of the organisation.
✨Tip Number 4
Don’t forget to apply through our website! It’s the best way to ensure your application gets seen by the right people. Plus, it shows you’re genuinely interested in being part of our caring community.
We think you need these skills to ace Medical Director, Medicare Grievances in Swindon
Some tips for your application 🫡
Tailor Your CV: Make sure your CV reflects the specific skills and experiences that match the Medical Director role. Highlight your clinical experience, communication skills, and any relevant work with Medicare or Medicaid.
Craft a Compelling Cover Letter: Your cover letter is your chance to shine! Use it to explain why you're passionate about this role and how your background makes you the perfect fit for our caring community at StudySmarter.
Showcase Your Decision-Making Skills: Since the role involves independent judgment on complex issues, be sure to include examples in your application that demonstrate your analytical skills and decision-making prowess.
Apply Through Our Website: We encourage you to apply directly through our website. It’s the best way for us to receive your application and ensures you’re considered for the position without any hiccups!
How to prepare for a job interview at Humana
✨Know Your Stuff
Make sure you brush up on your medical knowledge, especially around Medicare and Medicaid. Be ready to discuss your clinical experience and how it relates to the role. They’ll want to see that you can apply your expertise to real-world scenarios.
✨Showcase Your Communication Skills
As a Medical Director, you'll need to communicate complex medical information clearly. Practice explaining your past experiences in a way that’s easy to understand. Think about examples where you’ve had to convey difficult information to patients or colleagues.
✨Demonstrate Decision-Making Ability
Prepare to discuss situations where you had to make tough decisions independently. Highlight your analytical skills and how you approach complex problems. They’ll be looking for evidence of your judgement and ability to navigate challenging scenarios.
✨Align with Their Values
Research the company’s mission and values, especially their focus on improving consumer experiences. Be ready to share why you’re passionate about contributing to this goal and how your background aligns with their vision.