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The National Physician Leader relies on medical background and reviews health claims, requiring a solid understanding of how organization capabilities interrelate across department(s).
You will provide clinical leadership across home health and post-acute utilization management, while also driving strategic initiatives that improve quality, access, and cost of care.

This role blends:
Clinical decision-making (case review & UM oversight)
Team leadership
Enterprise influence and strategy execution

Lead the Future of Care Delivered at Home

At OneHome, we are transforming how care is delivered beyond the hospital bringing together home health, DME, infusion, and community-based care into one integrated experience.

As part of Humana, a national leader in value-based care, this role offers a unique opportunity to operate at the intersection of payer, provider, and home-based care delivery where clinical leadership directly shapes outcomes, cost, and experience at scale.

What Makes This Role Different 
1. Influence Care at Scale

• Impact care decisions for millions of Medicare Advantage members

• Shape how care is delivered across the entire post-acute continuum, not just one silo

• Operate in a payer-provider integrated model—a key advantage vs. traditional UM-only roles

2. Practice High-Impact, Modern Medicine

• Move beyond transactional reviews into strategic, outcomes-driven clinical leadership

• Lead initiatives in:

  • Hospital avoidance & SNF diversion

  • Home-based alternatives (Hospital at Home, advanced home care models)

  • Value-based partnerships

3. Lead in a Culture Built on Humanity & Performance
Your leadership is guided by The Humana Way—a culture system designed to create simpler, faster, better healthcare

You will lead by:

• Listening first (member + provider centricity)

• Simplifying complexity (removing friction from care delivery)

• Driving bold outcomes (not activity)

• Anticipating future needs (vs reacting)

• Building one team across silos

4. Competitive Rewards & Flexibility

•  Highly competitive executive-level compensation + bonus

•  Remote flexibility with national scope

•  Strong clinical leadership career path within Humana/OneHome

•  Opportunity to shape strategy—not just execute it

Key Responsibilities

Clinical Leadership & Medical Decision-Making

• Review and oversee post-acute medical director team for home health, SNF, DME and potentially others in time.                                                                                                 

• Lead, mentor, and support teams of clinical associates, managers, and specialized professionals within the department.

• Ensure clinical appropriateness using CMS, Medicare Advantage, and evidence-based guidelines

• Lead resolution of complex or escalated cases

• Maintain ~50% involvement in direct clinical review work

Post-Acute Strategy & Innovation

• Advance site-of-care optimization (home vs. facility-based care)

• Partner with internal teams to design and scale home-based care models

• Contribute to strategy for integrated post-acute networks and partnerships

Quality & Performance Improvement

• Drive improvements in:

• Readmissions and avoidable utilization

• HH episode/visit efficiency and SNF length of stay

• Member experience and care access

• Use analytics to identify variation and implement targeted interventions

Team Leadership & Development

• Lead and coach Medical Directors and clinical professionals

• Build a culture of accountability, collaboration, and continuous improvement

• Align team performance to enterprise goals and outcomes

Operational Excellence

• Improve utilization management workflows, turnaround times, and consistency

• Ensure regulatory compliance and audit readiness

• Optimize staffing models and clinical resource deployment

Cross-Functional Collaboration

• Care management

• Provider/network teams

• Clinical pr