Remote Molecular Diagnostics Medicare Medical Director

BlueCross and BlueShield of South Carolina; New York (NY); Teletrabalho; USD 206 000 - 414 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Subsidized health plans

401k retirement plan with companymatch

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Resumo da oferta

BlueCross BlueShield of South Carolina invites applications for the Molecular Diagnostics Medicare Medical Director role with Palmetto GBA, a subsidiary. The position oversees medical staff, analyzes utilization data, and develops medical policies to support Medicare coverage decisions.

Remote in the United States or onsite in Columbia, SC. Requires MD license, board certification, 5 years of post-graduate patient care, and strong communication skills. Sponsorship is not available at this time.

Qualificações

• MD with active medical license.
• Active state medical license and board certification.
• 5 years post graduate patient care experience.
• Excellent verbal and written communication; customer service, organizational and presentation skills.
• Microsoft Office Suite proficiency.

Responsabilidades

• Supports operations by reviewing medical and regulatory matters and developing adjudication criteria.
• Educates staff and medical community on medical policy and program administration.
• Develops and updates medical policy in collaboration with regulatory personnel and medical consultants.
• Reviews physician and provider practice pattern analyses and other data related to medical service utilization.
• Researches new or controversial medical procedures and technology.

Conhecimentos

Verbal & written comms

Customer service

Team leadership

Utilization review

Medical terminology

Formação académica

MD (Medical Doctor)

Ferramentas

Microsoft Office

Descrição da oferta de emprego

BlueCross BlueShield of South Carolina invites applications for the Molecular Diagnostics Medicare Medical Director role with Palmetto GBA, a subsidiary. The position oversees medical staff, analyzes utilization data, and develops medical policies to support Medicare coverage decisions.

Remote in the United States or onsite in Columbia, SC. Requires MD license, board certification, 5 years of post-graduate patient care, and strong communication skills. Sponsorship is not available at this time.