Chief Medical Officer and Policy Strategy Leader Onsite

Blue Cross Blue Shiel; Columbia (SC); Presencial; USD 190 000 - 290 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Subsidized health plans

401k retirement savings plan with 公司匹

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Resumo da oferta

BlueCross BlueShield of South Carolina is seeking a Chief Medical Officer, Contractor Medical Director to provide clinical and administrative oversight to medical staff and analyze medical review data. You will write and revise medical policies and liaise with regulators and providers.

The role requires a Doctorate in a related field, active medical license, and 5+ years of post-graduate clinical experience.

Qualificações

• Doctorate in a job-related field.
• Active state medical license and current board certification in a recognized specialty.
• 5 years post graduate experience in direct patient care.

Responsabilidades

• Support operations in the form of case review on both medical and regulatory matters.
• Develop claim adjudication criteria for situations requiring medical judgment.
• Provide input on issues and operational policies, processes, and procedures.
• Educate staff and medical community on various aspects of 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 a liaison between these entities and the contractors.
• Review physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization.
• Conduct research into new or controversial medical procedures and technology.

Conhecimentos

Verbal communication

Written communication

Customer service

Organizational skills

Presentation skills

Judgment

Negotiation

Leadership

Teamwork

Utilization review

Medical knowledge

Formação académica

Doctorate in a job-related field

Ferramentas

Microsoft Office

Descrição da oferta de emprego

BlueCross BlueShield of South Carolina is seeking a Chief Medical Officer, Contractor Medical Director to provide clinical and administrative oversight to medical staff and analyze medical review data. You will write and revise medical policies and liaise with regulators and providers.

The role requires a Doctorate in a related field, active medical license, and 5+ years of post-graduate clinical experience.