Physical Medicine and Rehabilitation Med

Internal Reference Number: R1049672
Summary As a member of the senior management team, the Physical Medicine and Rehabilitation Medical Director provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.Description

Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40-hours/week) Monday-Friday working REMOTE in the United States or ONSITE at our GPC location at 17 Technology Circle, Columbia, SC. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM.

What You'll Do:

Supports operations in the form of case review on both medical and regulatory matters.

Develops claim adjudication criteria for situations requiring medical judgment. Provides input on issues and operational policies, processes, and procedures.

Educates staff and medical community on various aspects of medical policy and program administration.

May develop and update medical policy in consultation with appropriate regulatory personnel, medical consultants, and professional societies.

Develops external relationships with the medical community and serves as liaison between these entities and the contractors.

Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization.

Conducts research into new or controversial medical procedures and technology.

To Qualify for This Position, You'll Need the Following:

Required Education: Doctorate in a job related field.

Required Experience:

5 years post graduate experience in direct patient care.

Required Software and tools: Microsoft Office

Required Skills and Abilities:

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 as well as a leader.

Knowledge of medical and utilization review... For full info follow application link.

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.