National Medical Director, Home-Based Care Programs

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The National Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for the medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care’s (and Conviva Senior Primary Care’s) Home-Based Care portfolio, serving the highest-need and most complex senior patients.

This role will lead clinical strategy, quality improvement, and care delivery innovation for chronically and temporarily homebound, polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy Advancement and Operations Director and works cross-functionally with operations, analytics, medical economics, technology, and finance teams to optimize patient outcomes, improve clinical workflows, and drive scalable models of care. The Medical Director will provide medical leadership to multidisciplinary teams, partner with vendor clinicians and care teams, and ensure the delivery of evidence-based, patient-centered care that reduces avoidable hospitalizations and enhances patient experience and safety.

Use your skills to make an impact

Key Responsibilities

Portfolio Scope

Integrated Home Care Program – Provide clinical leadership for the Integrated Home Care Program by overseeing in-home care delivery for bedbound and medically complex patients, ensuring alignment with national guidelines, CMS requirements, Humana policies, and clinical standards. Collaborate closely with primary care physicians and advanced practice providers to support high-quality, coordinated care.

Avoidable ED Impact – Lead medical strategy to reduce avoidable ED visits, including oversight of clinical protocols with vendor partners (e.g., Dispatch Health), ensuring appropriate triage and escalation for patients receiving urgent care at home.

Primary Care – Home Health care model integration – Develop and integrate clinical models to enhance coordination between primary care and home health providers, focusing on post-acute and longitudinal home health patients to minimize preventable (re)admissions.

Evaluate and champion new clinical programs that advance the Home-Based Care strategic plan.

Clinical Leadership & Excellence

Translate strategic initiatives into actionable clinical protocols, pathways, and guidelines, with measurable clinical outcomes.

Provide direct oversight of clinical operations in home-based care, ensuring alignment with best practices, regulatory standards, and organizational goals.

Monitor clinical quality, patient safety, and care outcomes, implementing evidence-based interventions to address gaps and optimize performance.

Collaborate with operational leaders to design and execute long-term clinical strategies for the Home-Based Care portfolio.

Strategic Clinical Expansion

Assess new markets for clinical expansion, evaluating population health needs, feasibility, and regulatory considerations.

Build scalable clinical infrastructure, including standardized training for clinicians, orientation materials, and ongoing education frameworks to support program growth.

Support technology and workflow innovation (e.g., telehealth, remote monitoring) to enhance care delivery and provider efficiency.

Team Leadership and Interdisciplinary Collaboration

Lead and mentor multidisciplinary clinical teams, fostering a culture of clinical excellence, collaboration, and continuous professional development.

Build strong relationships with internal and external clinical stakeholders, including vendor medical leadership, community partners, and regulatory agencies.

Partner with analytics teams to review clinical data and utilize insights for continuous program improvement.

Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities.

Quality Improvement and Outcomes Management

Develop and oversee robust clinical quality evaluation frameworks to monitor program outcomes, adherence to benchmarks, and ROI.

Analyze clinical data to identify opportunities for improvement and implement rapid cycle process improvement methodologies.

Lead the development and implementation of corrective action plans for identified clinical performance gaps.

Maintain current knowledge of industry trends, evidence-based guidelines, and regulatory requirements impacting home-based care.

Resource Management and Clinical Oversight

Provide clinical input into budget planning and resource allocation to support clinical program needs.

Oversee the procurement and implementation of clinical equipment, technology, and supplies necessary for home-based care delivery.

Participate in the evaluation, selection and onboarding of clinical personnel and vendor partners.

Required Qualifications

Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree

A current and unrestricted license in at least one jurisdiction and willing and able to obtain additional license, if required

Board certification in Internal Medicine, Family Medicine, Geriatrics, or related specialty

5-7 years of progressively responsible clinical leadership experience, preferably in value-based care, home-based care, or complex care management

2-5 years of experience managing or mentoring clinical teams

Experience in a large, matrixed health care organization with demonstrated ability to influence leaders and stakeholders across direct and indirect reporting lines

Strong clinical analytic skills, including ability to interpret and act on qualitative and quantitative data to improve care outcomes

Excellent collaboration, communication, and interpersonal skills

Experience managing change, modeling adaptability, and driving clinical innovation

Ability to explain complex clinical concepts to non-clinical audiences

Preferred Qualifications

Fellowship training in Geriatrics, Hospice and Palliative Medicine, or similar subspecialty.

Master’s degree in business / healthcare administration, Public Health, or related field.

Experience in medical leadership within value-based, risk-bearing organizations.

Demonstrated success leading clinical quality improvement initiatives in home-based or post-acute care settings.

Experience collaborating with vendor clinicians and external partners.

Proficiency with health information technology, telemedicine, and remote patient monitoring solutions.

Knowledge / Skills / Abilities / Competencies Required

Strong clinical leadership skills with ability to inspire and engage interdisciplinary teams

Exceptional communication and interpersonal skills; ability to collaborate effectively with clinicians, executives, and operational leaders.

Advanced knowledge of Medicare regulations, value-based care principles, and best practices for complex care management.

High-level analytical and problem-solving skills; ability to interpret and act on clinical and operational data.

Deep understanding of clinical operations, process improvement, and the drivers of quality and value in senior care.

Experience with developing and implementing clinical protocols, care pathways, and provider education programs.

Ability to manage change and drive adoption of innovative care models in a large, matrixed organization.

Commitment to continuous learning and professional development.

Computer proficiency with EMR systems, word processing, spreadsheets, and presentation software.

Additional Information

Remote position with occasional travel (20-40%) to various CenterWell and Conviva markets and team on-sites.

Must maintain active, unrestricted medical license

Participation in national committees and initiatives may be required.

Adherence to all PCO policies, as well as applicable state and federal regulations.

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay 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.

$270,800 - $378,800 per year

This 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline : 09-23-2025

About us

About CenterWell Senior Primary Care : CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer "

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