Corporate MD Grievance & Appeals
Company websitehumana.com (Humana, opens in new tab)
Base salary $246,100 to $344,200
Employer-published annual base salary, USD. Advertised base range in United States
You apply on the employer's own site. Six Figure Work does not handle applications.
- LocationUnited States
- WorkplaceWorkplace not stated
- Status at last checkSource accepting applications when checked
- Last checked (24 min ago) · observed since
About this job
Become a part of our caring community
The Corporate Medical Director relies on medical background and reviews of medical records for appeals decisions. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial.The Corporate Medical Director provides clinical interpretation and makes determinations regarding the appropriateness of services delivered by other healthcare professionals, in accordance with established review policies, procedures, and performance standards. The Corporate Medical Director exercises independent judgment in addressing complex issues related to job responsibilities and associated tasks, applying critical analysis to variable factors and determining the most appropriate course of action.
- Provide medical interpretation and clinical judgment regarding the appropriateness, necessity, and quality of services rendered by other healthcare professionals.
- Perform or oversee clinical reviews of grievance and appeal cases for assigned markets, member populations, or condition-specific areas.
- Ensure all determinations are made in compliance with medical review policies, regulatory requirements, internal procedures, and performance standards.
- Serve as a clinical subject matter expert for complex grievance and appeal matters involving Medicare, Medicaid, and Commercial products.
- Make independent decisions on highly complex clinical issues, including cases with variable factors, incomplete information, or competing clinical considerations.
- Act as a clinical resource for issues involving home health, rehabilitation, inpatient, outpatient, and transitional care services.
- Ensure appeal and grievance reviews reflect knowledge of managed care operations, including Medicare, Medicaid, and Commercial line-of-business requirements.
- Partner with cross-functional teams to improve consistency, turnaround times, compliance, and member-centered decision-making.
- Contribute to initiatives focused on improving the member experience and reducing preventable escalations or dissatisfaction.
- Provide expertise across relevant clinical specialties such as Internal Medicine, Family Practice, Geriatrics, and Hospital Medicine.
- Support holidays and weekends as required based on business needs. After-hours coverage as required to maintain regulatory and operational review timelines.
- Maintain awareness of emerging regulations, accreditation standards, and medical policy changes affecting grievance and appeal determinations.
Use your skills to make an impact
Required Qualifications
- MD or DO degree
- Current, unrestricted licensure in at least one jurisdiction, with the ability and willingness to obtain additional unrestricted licenses, as needed, for states within the assigned region.
- No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
- Board Certified in an approved ABMS Medical Specialty
- Prompt professional communication skills written and verbally
- 5 years of established clinical experience post residency
- Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Medical utilization management experience in MA Grievances and Appeals
- Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
- Internal Medicine, Family Practice, Geriatrics, Hospitalist, Anesthesiology, Physical Medicine and Rehabilitation, Emergency Medicine, Neurology, and General Surgery clinical specialists
Work Style: Fully remote living in the contiguous USA. Occasional travel to Humana's offices for training or meetings may be required.
Work Hours: Typical business hours are Monday-Friday, 8am - 5pm Some flexibility might be possible, depending on business needs. Holidays and weekends as required by needs of the business.
Very minimal travel might be required for training, meetings, and/or conferences
Interview Format
As part of our hiring process, we will be using on-demand technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers with an enhanced method for decision-making through on-demand candidate assessments.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes.
Your on-demand assessment will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
SSN Task via Workday
Should you be extended a formal employment offer you will receive a request to enter your SSN into our Workday system to scan for duplicate profiles.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$246,100 - $344,200 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 11-29-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Source: Humana on Workday · View original posting (opens in new tab)
Pay in context
This role's base floor ($246,100) is above 66% of the 3,847 Healthcare Clinical roles nationwide listed on this site. Their median floor is $185,498; the middle half runs from $124,308 to $263,102.
Only jobs on this site count, and each one publishes a base salary of $100,000 or more, so this compares six-figure jobs with each other, not with the whole market. Computed Nov 8, 2026.
This listingCorporate MD Grievance & Appeals$246,100 to $344,200
Primary Care Physician$255,000 to $298,500
Primary Care Physician$255,000 to $298,500
Primary Care Physician$255,000 to $298,500
Primary Care Physician$255,000 to $298,500
Primary Care Physician$255,000 to $298,500
Primary Care Physician$255,000 to $298,500
Chart as a table
| Role | Published base |
|---|---|
| Corporate MD Grievance & Appeals (this listing) | $246,100 - $344,200 |
| Primary Care Physician | $255,000 - $298,500 |
| Primary Care Physician | $255,000 - $298,500 |
| Primary Care Physician | $255,000 - $298,500 |
| Primary Care Physician | $255,000 - $298,500 |
| Primary Care Physician | $255,000 - $298,500 |
| Primary Care Physician | $255,000 - $298,500 |
Observed changes
- First observed on the employer's board
- Began meeting the published-salary criteria
- Observed since
- Employer-stated posting date
- 2026-11-06
Where this pay comes from
Location as the employer wrote it: Remote Nationwide
$246,100 - $344,200 per year
- Method
- Employer text, read with fixed rules and re-verified
- Checked
- Rule set
- us-base-v2
The pay passage appears in the employer's own job text. Fixed, deterministic rules located it, and the passage below was checked against the stored copy of the posting.
What we verified
- The pay figures come from the employer's own listing, quoted exactly above.
- The pay is an annual base salary in US dollars with a minimum of at least $100,000.
- The role was publicly listed on the employer's job board when last checked.
We do not verify what the employer will actually offer, whether the employer is still recruiting for the role, or anything beyond what the employer published. Full methodology.