• Medical Director - Florida

    Humana (Columbia, SC)
    …such as MCG(R) or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist , Emergency Medicine clinical specialists + Advanced degree 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. + The curiosity to… more
    Humana (10/03/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Columbia, SC)
    …interaction, etc. + Internal Medicine, Family Practice, Geriatrics, Hospitalist , Anesthesiology, Physical Medicine and Rehabilitation, Emergency Medicine, and ... General Surgery clinical specialists **Work at Home Guidance** 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… more
    Humana (10/02/25)
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  • Medical Director-Payment Integrity

    Humana (Columbia, SC)
    …national guidelines such as MCG(R) or InterQual + Internal Medicine, Hospitalist , Family Practice, Geriatrics, Emergency Medicine clinical specialists + Advanced ... degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Typically reports to a Lead… more
    Humana (09/26/25)
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  • Medical Director - Mid West Region

    Humana (Columbia, SC)
    …practice, including specialties of Internal Medicine, Family Practice, Geriatrics, Hospitalist , Emergency Medicine clinical specialists + 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. + The curiosity to learn and the flexibility to adapt to… more
    Humana (09/16/25)
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  • Corporate Medical Director - Medicare Grievances…

    Humana (Columbia, SC)
    …ABMS Medical Specialty + **Internal Medicine, Family Practice, Geriatrics, Hospitalist , Emergency Medicine, or Physical Medicine and Rehab, Anesthesiology and ... General Surgery trained** + Excellent written and communication skills + 5 years of established, post-residency clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
    Humana (09/05/25)
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  • Market CMO - South Carolina

    CenterWell (Columbia, SC)
    …Oversee daily operations of physician services. . Build strong relationship with specialist, hospitalist , SNF and other providers to form a narrow network of quality ... service focused on senior population health . Responsible for medical interpretation, reviews, and decisions as required for plan administration. . Monitor medical performance and provide guidance to ensure that the quality of care being provided meets… more
    CenterWell (08/29/25)
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  • Medical Director - Northeast Region

    Humana (Columbia, SC)
    …such as MCG(R) or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist , Emergency Medicine clinical specialists + Advanced degree 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. + The curiosity to… more
    Humana (07/25/25)
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