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Medicaid Medical Director — Remote Utilization Leader

Remote / Online - Candidates ideally in
Columbia, Lexington County, South Carolina, 29228, USA
Listing for: Humana Inc
Remote/Work from Home position
Listed on 2026-01-20
Job specializations:
  • Healthcare
    Healthcare Consultant, Healthcare Administration, Healthcare Management
Salary/Wage Range or Industry Benchmark: 223800 - 313100 USD Yearly USD 223800.00 313100.00 YEAR
Job Description & How to Apply Below
Location: Columbia

A leading healthcare organization is seeking a Medical Director to ensure health claims compliance and provide clinical interpretation on service agreements. The ideal candidate should have a medical degree (MD/DO) and 5+ years of clinical patient care experience, ideally with Medicare populations. Responsibilities include utilization management of care received by members and engaging in grievance reviews. A commitment to collaboration within teams and excellent communication skills are essential.

The position is remote, with occasional travel required.
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