Medical Director – Acute Rehab

Humana

. Determine whether to authorize requested services, level of care, and site of service .

Posted 10/14/2026full-timeRemote • United StatesLead💰 $223,800 - $313,100 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Management and Clinical Decision-Making, ensuring compliance with National Clinical Guidelines and CMS Requirements. Possesses strong Analytical and Interpretation Skills, with a focus on Quality Management and Acute Inpatient Rehabilitation.

Highest-signal resume keywords

MD Or DO Degree5+ Years Of Direct Clinical Patient Care ExperienceBoard Certified In An Approved ABMS Or AOA Medical SpecialtyUtilization Management ExperienceKnowledge Of Managed Care Industry

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Utilization ManagementClinical ReviewAnalytic SkillsDocumentation StandardsCritical ThinkingMedical InterpretationQuality ManagementAcute Inpatient RehabilitationCase ManagementHealthcare Compliance

Soft Skills

CommunicationCollaborationConflict ResolutionTeam ParticipationMentorship

Certifications & Qualifications

Current And Unrestricted Medical LicenseBoard Certification

Industry Keywords

Medicare AdvantageManaged MedicaidHealthcare ProvidersIntegrated Delivery SystemsPublic HealthPopulation HealthSocial Determinants Of HealthGrievance And Appeals ReviewsClinical StandardsPHI/HIPAA Compliance

About the role

Key responsibilities & impact

Determine whether to authorize requested services, level of care, and site of service
Conduct computer-based reviews of moderately complex to complex clinical scenarios
Review submitted clinical records and prioritize daily work
Communicate decisions to internal associates
Provide medical interpretation and determinations on acute inpatient rehabilitation authorization requests
Ensure alignment with national clinical guidelines, CMS requirements, Humana policies, and clinical standards
Collaborate with team members, departments, Humana colleagues, and clinical leadership
Participate in structured and mentored training programs
Apply critical thinking and maintain high standards in documentation and decision-making
Meet enterprise expectations and compliance timelines independently
Conduct utilization management of care received by members in an assigned market, population, or condition type
Contribute to grievance and appeals reviews
Participate on project teams or organizational committees
Discuss cases with external physicians by phone and gather additional clinical information
Resolve conflicts when needed

Requirements

What you’ll need

MD or DO degree
5+ years of direct clinical patient care experience after residency or fellowship
Board Certified in an approved ABMS or AOA Medical Specialty, with continued certification throughout employment
Current and unrestricted license in at least one jurisdiction, with willingness to obtain additional licenses
No current sanction from Federal or State Governmental organizations
Ability to pass credentialing requirements
Analytic and interpretation skills
Prior experience participating in teams focused on quality management, utilization management, and acute inpatient rehabilitation
Knowledge of the managed care industry, including Medicare Advantage, Managed Medicaid, hospitals/Integrated Delivery Systems, health insurance, and healthcare providers
Utilization management experience in a medical management review organization
Background in Physical Medicine and Rehabilitation, Internal Medicine, Family Practice, Geriatrics, or Hospitalist practice
Applicants must live in the contiguous United States
Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information
Home internet service with at least 25 Mbps download and 10 Mbps upload speed
Preferred: advanced degree such as MBA, MHA, or MPH
Preferred: exposure to Public Health, Population Health, analytics, and business metrics
Preferred: experience working with Case managers or Care managers on complex case management and familiarity with social determinants of health

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off
Company and personal holidays
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance
Work-from-home arrangement
Occasional travel to Humana offices for training or meetings