Physical Medicine and Rehabilitation Medical Director

🕒 August 5

🌺 Hawaii, South Carolina, +2 more states – Remote

🌺 Hawaii – Remote 🌴 South Carolina – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 13%

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BlueCross BlueShield of South Carolina

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

BlueCross BlueShield of South Carolina is a leading health insurance provider that offers a variety of health plans, including individual and family plans, Medicare options, and group health plans. The organization focuses on providing coverage and resources for members, employers, and healthcare providers, ensuring access to quality healthcare services. With a commitment to promoting healthier lifestyles and supporting community health, BlueCross BlueShield of South Carolina plays a vital role in the healthcare landscape of the region.

📋 Description

• Provide administrative oversight to the medical staff • Analyze medical review utilization data • Support operations through case review on medical and regulatory matters • Develop claim adjudication criteria for situations requiring medical judgment • Provide input on operational policies, processes, and procedures • Educate staff and the medical community on medical policy and program administration • Develop and update medical policy with regulatory personnel, medical consultants, and professional societies • Develop external relationships with the medical community • Serve as liaison between medical entities and contractors • Review physician and provider practice pattern analyses and statistical data related to unusual medical service utilization • Research new or controversial medical procedures and technology • May write and revise medical policies

🎯 Requirements

• Doctorate in a job-related field • 5 years of post-graduate experience in direct patient care • Proficiency with Microsoft Office • Excellent verbal and written communication skills • Excellent customer service, organizational, and presentation skills • Good judgment skills • Proficiency in spelling, punctuation, and grammar • Ability to persuade, negotiate, or influence others • Ability to work as a team member and leader • Knowledge of medical and utilization review techniques • Active state medical license • Current board certification in a recognized specialty • Ability to obtain a security clearance • Must be a U.S. Citizen • Not eligible for sponsorship now or in the future • Preferred: health insurance industry experience • Preferred: inpatient rehabilitation experience • Preferred: Medicare policy knowledge and experience

🏖️ Benefits

• Subsidized health plans • Dental and vision coverage • 401k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more • Diverse and inclusive workplace • Reasonable accommodations for disabilities, pregnancy-related conditions, and sincerely held religious beliefs