Full-Time
Physical Medicine and Rehabilitation Medical Director
BlueCross BlueShield of South Carolina
Health insurance and plan administration
Compensation Overview
$206k - $413.5k/yr
No H1B Sponsorship
New Mexico, USA + 50 more
More locations: Washington, USA | Kansas, USA | Pennsylvania, USA | North Dakota, USA | Oregon, USA | Delaware, USA | Iowa, USA | California, USA | Washington, DC, USA | Vermont, USA | Wyoming, USA | Connecticut, USA | Texas, USA | Montana, USA | Florida, USA | New Hampshire, USA | Nevada, USA | South Carolina, USA | South Dakota, USA | Georgia, USA | Arizona, USA | Mississippi, USA | Tennessee, USA | Virginia, USA | Arkansas, USA | Minnesota, USA | Colorado, USA | Nebraska, USA | Rhode Island, USA | Utah, USA | Kentucky, USA | West Virginia, USA | New York, NY, USA | Maryland, USA | Hawaii, USA | Wisconsin, USA | Maine, USA | Massachusetts, USA | North Carolina, USA | Oklahoma, USA | Missouri, USA | Ohio, USA | New Jersey, USA | Indiana, USA | Louisiana, USA | Alaska, USA | Michigan, USA | Illinois, USA | Alabama, USA | Idaho, USA
Remote
Remote within the United States; an on-site option is available in Columbia, South Carolina.
US Citizenship Required
PhD
 Medical, Clinical & Veterinary (1) |
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- A doctorate in a job-related field is required.
- At least five years of postgraduate experience in direct patient care is required.
- Applicants must be able to obtain a security clearance and must be U.S. citizens.
- Proficiency with Microsoft Office is required.
- Active state medical licensure and current board certification in a recognized specialty are required.
- Knowledge of medical and utilization review techniques is required.
- The role requires strong verbal and written communication, customer service, organizational, presentation, judgment, spelling, punctuation, grammar, persuasion, negotiation, influence, teamwork, and leadership abilities.
- Provide administrative oversight to the medical staff.
- 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 in consultation with regulatory personnel, medical consultants, and professional societies.
- Develop external relationships with the medical community and serve as liaison between those entities and contractors.
- Review physician and provider practice pattern analyses and other statistical data related to unusual medical service utilization.
- Conduct research into new or controversial medical procedures and technology.
- Analyze medical review utilization data and research new medical procedures or technology.
- Experience in the health insurance industry.
- Experience in inpatient rehabilitation.
- Knowledge of and experience with Medicare policy.
BlueCross BlueShield of South Carolina is a South Carolina-owned mutual health insurer and health-plan administrator. It offers individual, employer, Medicare and other coverage while operating provider networks, member services, claims and administrative programs. The organization also supports government and commercial health contracts through related businesses and specialized operations. This profile refers specifically to the South Carolina company, not the national Blue Cross Blue Shield Association, and centers on its role connecting members, employers, healthcare providers and public programs.
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