Physical Medicine and Rehabilitation Medical Director

BlueCross BlueShield of South Carolina; Columbia (SC); Remote; USD 206,000 - 414,000; Full time

Job summary

A leading company in the health insurance sector is seeking a Physical Medicine and Rehabilitation Medical Director to oversee operations and develop medical policies. This full-time role offers a competitive salary and benefits, with opportunities for professional growth and community engagement.

Benefits

Subsidized health plans

Dental and vision coverage

401k with company match

Life insurance

PTO

Education assistance

Service recognition

Discounts

Qualifications

• Doctorate in a relevant field required.
• 5+ years of post-graduate experience in direct patient care.
• Proficiency in Microsoft Office and strong communication skills.

Responsibilities

• Support operations through case review on medical and regulatory matters.
• Develop claim adjudication criteria requiring medical judgment.
• Educate staff and the medical community on medical policies.

Skills

Communication

Customer Service

Organizational Skills

Presentation Skills

Teamwork

Leadership

Medical Judgment

Education

Doctorate in a relevant field

Tools

Microsoft Office

Job description

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Physical Medicine and Rehabilitation Medical Director

Apply remote type: Remote locations: Columbia, South Carolina; W@H Georgia; W@H Vermont; W@H Hawaii; W@H North Carolina. Time type: Full time. Posted on: Posted 7 Days Ago. End Date: June 13, 2025 (16 days left to apply). Job requisition id: R1043165

Summary

Why should you join the BlueCross BlueShield of South Carolina family of companies? We've been part of the national landscape for over seven decades, rooted in the South Carolina community. We are the largest insurance company in South Carolina and a leading administrator of government contracts, operating a sophisticated data processing center in the Southeast. Our diverse subsidiary companies strengthen our business. We are committed to outstanding customer service. If you share this philosophy, consider joining us!

Description

Logistics: Palmetto GBA, a subsidiary of BlueCross BlueShield of South Carolina.

Location: This full-time position (40 hours/week), Monday-Friday, is onsite at our GPC location at 17 Technology Circle, Columbia, SC, or remote. Work hours are 8:00 AM - 5:00 PM.

What You’ll Do:

• Support operations through case review on medical and regulatory matters.
• Develop claim adjudication criteria requiring medical judgment. Provide input on operational policies, processes, and procedures.
• Educate staff and the medical community on medical policies and program administration.
• Develop and update medical policies in consultation with regulatory personnel, medical consultants, and professional societies.
• Build external relationships with the medical community and serve as liaison.
• Review practice pattern analysis and statistical data related to medical service utilization.
• Research new or controversial medical procedures and technology.

Qualifications:

• Doctorate in a relevant field.
• At least 5 years of post-graduate experience in direct patient care.
• Proficiency in Microsoft Office.
• Excellent communication, customer service, organizational, and presentation skills.
• Good judgment, spelling, punctuation, and grammar skills.
• Ability to persuade, negotiate, and influence others.
• Teamwork and leadership abilities.
• Knowledge of medical and utilization review techniques.

Licenses and Certifications: Active state medical license and current board certification in a recognized specialty.

Preferred Qualifications:

• Board certification in Physical Medicine and Rehabilitation (strongly preferred).
• Experience in health insurance industry and inpatient rehabilitation.
• Knowledge of Medicare policies.

Benefits: Subsidized health plans, dental and vision coverage, 401k with company match, life insurance, PTO, on-site amenities, education assistance, service recognition, and discounts.

Our Commitment: We value diversity and inclusion, providing opportunities for skill development and career growth.

Next Steps: Our team reviews applications, conducts interviews with qualified candidates, and may contact you for further information.

Pay Range: Minimum: $206,011; Midpoint: $309,767; Maximum: $413,523. Salary depends on experience, location, and internal factors.

EEO Statement: We promote nondiscrimination and provide reasonable accommodations. For assistance, contact [e-mail] or call 800-288-2227, ext. 47480.

Participating in E-Verify and complying with pay transparency laws, we are an Equal Opportunity Employer.