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South Carolina’s largest and oldest health insurance company
Associate Medical Director DME
Location
United States
Posted
108 days ago
Salary
$206K - $413K / year
Seniority
Lead
No structured requirement data.
Job Description
Associate Medical Director DME
BlueCross BlueShield of South Carolina
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: As member of the Pricing, Data Analysis and Coding (PDAC) team, the Associate Medical Director DME provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical devices and technology, and acts as a resource to CMS, DMEPOS stakeholders, internal staff, on issues concerning medical device coding and DMEPOS policies. In this role, you will also oversee coding integrity efforts as well as write and revise coding advisory articles with regard to Medicare policy and procedure. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. This role is located at our Government Programs Building at 17 Technology Circle, Columbia, SC OR can be REMOTE in the United States. There will be required travel for this position. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. 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: Doctoral degree Medical Doctor (MD) with current active license to practice medicine. - Required Experience: - Five years post graduate experience in direct patient care. - Required Skills and Abilities: - Excellent verbal and written communication skills. - Excellent customer service, organizational, and presentation 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 techniques. - Required Software : Microsoft Office Software - Required License and Certificate: Active state medical license and current board certification in a recognized specialty. We Prefer That You Have the Following: - Certified Professional Coding is preferred - Knowledge of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) - Medicare A/B MAC or DME MAC - Experience working in rehabilitation - Three or more years in the healthcare insurance industry, a utilization form or other administrative experience in a health-related field that involved developing coverage and coding policies and guidelines. - Experience involving development of coverage and coding policies and guidelines under a Medicare program contract is preferred. Our comprehensive benefits package includes the following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. - Subsidized health plans, dental and vision coverage - 401k retirement savings plan with company match - Life Insurance - Paid Time Off (PTO) - On-site cafeterias and fitness centers in major locations - Education Assistance - Service Recognition - National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who are the most qualified, with prioritization given to those candidates who demonstrate the required qualifications. Pay Range Information: Range Minimum $206,011.00 Range Midpoint $309,767.00 Range Maximum $413,523.00 Pay Transparency Statement: Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity. Equal Employment Opportunity Statement 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 individuals with disabilities and protected 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. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.
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Nurse Practitioner / Physician Assistant
Workit HealthWorkit Health is the leading provider of telemedicine treatment for substance abuse disorders, offering medication-assisted treatment, online therapy, primary care, and psychiatric
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a Nurse Practitioner or Physician Assistant at Workit Health, you will be responsible for collaborating with a physician to provide whole-person care to patients with substance use disorders via our telehealth platform. Currently all of our positions are remote until further notice. - Co-facilitate virtual shared medical appointments and individual appointments by providing clinical assessments, treatments, and medication management. - Conduct new patient evaluations. - Make appropriate assessments, treatment plans, and referrals for patient problems. - Prescribe and monitor medications for opioid use disorder and alcohol use disorder. - Provide patient education and referrals, specific to patients assessed needs. - Maintain standards of confidentiality, HIPAA and 42 CFR Part II. - Utilize strong communication skills, verbal and written. - Maintain accurate patient records in EMR system. - Provide excellent member experiences resolving member inquiries and ensure our members’ needs are placed first. - Commitment to Harm Reduction philosophy in all aspects of clinical practice. *Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time. Qualifications - 1 year of experience as a Nurse Practitioner or Physician Assistant - Active State Nurse Practitioner or Physician Assistant license in good standing in any of the following states: FL, IL, MI, OH, NJ, or TX - Minimum of 1 year experience in addiction medicine required - Experience prescribing SUD medications - Experience with harm reduction - Active DEA license - Current BLS certification - Willingness to obtain licensure in additional states - Ability to adapt and be flexible in a changing and evolving work environment - Ability and willingness to complete work independently online; familiarity with Google Drive, spreadsheets, documentation, video conferencing, and secure email - Professionalism, punctuality, and reliability a must - Enthusiasm for revolutionizing the way addiction is addressed and treated is necessary. Benefits - 5 weeks PTO (includes your birthday, 2 mental health days, and 2 floating holidays!) - 11 paid holidays - Comprehensive health, dental, pharmacy, and vision insurance with options to fit your family's needs - Company contributions to dependent premiums at higher than market rates (65%) - 12 weeks paid Parental Leave after 1 year of employment (includes maternity, paternity, adoption, and all ways in which our people build modern families) - 401k + matching - Healthcare & dependent care Flexible Spending Accounts (FSA) - Flexible schedules and flex-time work for all full-time and part-time employees - Employee assistance program, complete with financial coaching and counseling sessions - Professional development allowance for healthcare providers - Opportunities for professional development and growth within the company - Fully remote roles throughout the company - Vibrant, employee-driven cultural initiatives including multiple ERG groups - Colleagues who care deeply about closing health disparity gaps within the addiction space for underserved populations
National Director, Multiethnic Ministry
InterVarsity Christian FellowshipInterVarsity Christian Fellowship/USA is both an equal opportunity employer and a faith-based religious organization. We conduct hiring without regard to race, color, ancestry, national origin, citizenship, age, sex, marital status, parental status, membership in any labor organization, political ideology, or disability of an otherwise qualified individual. The status of InterVarsity Christian Fellowship/USA as an equal opportunity employer does not prevent the organization from hiring staff based on their religious beliefs so that all staff share the same religious commitment. Pursuant to the Civil Rights Act of 1964, Section 702 (42 U.S.C. 2000e 1(a)) InterVarsity Christian Fellowship/USA has the right to, and does, hire only candidates who agree with InterVarsity’s Statement of Agreement: Purpose and Doctrinal Basis because InterVarsity believes that each and every staff plays a vital role in advancing InterVarsity’s mission and purposes.
National Director, Multiethnic Ministry (Focused Ministries) Work Location: Remote - USA Job Type: Full time To advance the purpose of InterVarsity, this position will equip InterVarsity to grow ministries that embody our value for ethnic reconciliation and justice. Serving a wide diversity of students and faculty, the Director, Multiethnic Ministries will provide strategic leadership to (1) plant and grow more intentionally diverse chapters on campus, and (2) engage more students and faculty with formation experiences in ethnic reconciliation and justice, such as short-term cross-cultural immersions. Application deadline is 3/02/2026. MAJOR RESPONSIBILITIES Spiritual Growth: - Model spiritual and personal maturity as a disciple of Jesus Christ, reflecting love for God, God’s word, God’s people of every ethnicity and culture, and God’s purposes in the world - Practice spiritual disciplines that lead to spiritual vitality - Pursue spiritual relationships and involvement in a worshipping community - Work toward “self-leadership” characterized by self-awareness, self-management, social awareness, and relational integrity - Be a lifelong learner who prizes the discipleship of the mind, particularly staying current on issues related to ethnic reconciliation, justice, diversity, community development, evangelism, and the church in our society Ministry Leadership: - In partnership with the Field EVP and Focused Ministries VP, articulate broadly InterVarsity’s vision for ethnic reconciliation and justice on campus - In partnership with Field Leadership Team and Strategic Plan leaders, develop and implement strategies to plant and grow multiethnic chapters that effectively reach diverse corners of campus - As a member of the Focused Ministries Directors Team, provide vision, strategic leadership, planning, consulting, and decision-making for growing the diversity of students and faculty engaged by InterVarsity - Develop programs and resources to engage diverse chapters and participants with our value for ethnic reconciliation and justice (e.g. cross-cultural programs, multiethnic large groups, cross-cultural training, etc.) - Promote the integration of ethnic reconciliation and justice into student and faculty events and conferences Organizational Leadership: - Contribute to the Focused Ministries Directors Team to support mutual learning and the accomplishment of team goals and pursuit of the 2030 Calling - Contribute biblical, theological, and practical reflection for the Fellowship on issues relating to ethnic reconciliation and justice - In partnership with the VP, Focused Ministries, manage the annual process to allocate national financial resources to ethnic minority staff - As assigned, support Ethnic Directors in initiatives to recruit, place, and fund ethnic minority staff - Mentor, equip, and multiply multiethnic ministries leaders across the Fellowship - Recruit, hire, and supervise department staff - Equip and develop department staff through training, professional development and spiritual formation - Engage responsively, and carry out management responsibilities as defined by the VP, Focused Ministries - Ensure that department strategies align with InterVarsity’s Doctrinal Basis, Purpose Statement, Core Commitments, 2030 Calling, and National Initiatives - Establish fruitful external partnerships that will bolster our work in ethnic reconciliation and justice Ministry Partnership Development - Develop Ministry Partners who will give financially and prayerfully support our mission - Secure funds for assigned budget for the Director position - Partner with Development to raise funds for the department and strategic initiatives - Communicate with Ministry Partners on a regular basis - Maintain sound financial status of department through management of budgeting, fund development, and expense control - Provide oversight and accountability for staff Ministry Partnership Development Work Environment/Physical Requirements: - A designated home office - Required travel includes, but is not limited to: Ministry Partner Development meetings, Multiethnic team meetings, and InterVarsity-sponsored training, meetings, and conferences QUALIFICATIONS - Annually affirm InterVarsity’s Statement of Agreement (Doctrinal Basis and Purpose Statement). Abide by InterVarsity’s Code of Conduct. Believe and behave consonantly with InterVarsity’s Human Sexuality Theological Paper. Affirm and behave consonantly with InterVarsity’s “Women in Ministry Statement of Affirmation.” - Bachelor’s degree required; graduate degree is preferred - Minimum of eight years of campus ministry leadership experience, preferably with at least three years with InterVarsity - Minimum of five years’ experience leading ministries for intentionally diverse audiences - Demonstrated abilities in cross-cultural communication, conflict resolution, and ethnic reconciliation - Demonstrated experience managing and implementing successful, comprehensive ministry programs to achieve goals - Desire to stay current with developments in race relations and multiethnic issues - Significant theological acuity and spiritual maturity - Expert knowledge of funding needs and challenges of ethnic minority staff - Demonstrated ability to raise funds for staff and programs - Evidence of being a life-long learner and willingness to receive ongoing training - Excellent verbal and written communication skills - Ability to work independently without close supervision - A working knowledge of current Microsoft software applications (Word, Access, Excel, and PowerPoint) - Ability to travel extensively InterVarsity is a national collegiate ministry, serving on 675 campuses with 26,000 committed student and faculty participants. Over our 85-year history, our ministries have sought to serve, include, and empower people from every ethnicity and culture. In recent years, this has been expressed through contextualized ministries focused on, among others, Black, Native, Latino, Asian, and international background students and faculty. Our value for multi-ethnic diversity has not waned, and it is needed at this moment more than ever. InterVarsity is seeking a seasoned ministry leader to become our National Director of Multiethnic Ministry. This new department will collaborate with other InterVarsity leaders, including our ethnic focused ministry directors, to establish and advance intentionally diverse witnessing communities reaching multiple corners of campus with the gospel. Through these communities, and other support structures such as short-term missions experiences, we hope to multiply students and faculty with a lifelong commitment to ethnic reconciliation and justice. 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Benefits include the following: - 403(b) Retirement Savings Plan - 403(b) matching contributions - Dental insurance - Employee assistance program - Employee discounts - Flexible work schedule - Flexible spending accounts - Health insurance - Health savings account - Life insurance - Paid time off - Parental leave - Professional development assistance - Vision insurance Equal Employment Opportunity: InterVarsity Christian Fellowship/USA is both an equal opportunity employer and a faith-based religious organization. We conduct hiring without regard to race, color, ancestry, national origin, citizenship, age, sex, marital status, parental status, membership in any labor organization, political ideology, or disability of an otherwise qualified individual. The status of InterVarsity Christian Fellowship/USA as an equal opportunity employer does not prevent the organization from hiring staff based on their religious beliefs so that all staff share the same religious commitment. 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Specialty Operations Tech 2 - Pharm Ops
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This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Specialty Operations Pharmacy Technician 2 supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications. This role involves performing varied activities and moderately complex administrative, operational, and customer support assignments. - Performs computations and typically works on semi-routine assignments. - May contact physicians for prescription clarification and enter prescription orders into the system. - Supports Pharmacists and Patients by ensuring adherence to Specialty Rx specific operational processes and programs. - Communicates effectively with patients and providers to optimize health outcomes. - Works within defined parameters to identify work expectations and quality standards. - Has some latitude over prioritization and timing, working under minimal direction. - Follows standard policies and practices that allow for some opportunity for interpretation and independent discretion. Qualifications - Must have an active license with the Board of Pharmacy in the appropriate state. - Certified Pharmacy Technician. Requirements - Schedule: Monday-Friday, 2:30 PM-11 PM EST. - Travel: Occasional travel to Humana's offices for training or meetings may be required. - Scheduled Weekly Hours: 40. Benefits - Medical, dental, and vision benefits. - 401(k) retirement savings plan. - Time off including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave. - Short-term and long-term disability. - Life insurance. - Many other opportunities to support whole-person well-being. Pay Range The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year Company Description CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. - Cares for patients with chronic and complex illnesses. - Offers personalized clinical and educational services to improve health outcomes and drive superior medication adherence. CenterWell, a Humana company, creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and the fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional, and social wellness of our patients. - Part of Humana Inc. (NYSE: HUM). - Offers stability, industry-leading benefits, and opportunities to grow yourself and your career. - Employs more than 30,000 clinicians committed to putting health first. - Provides flexible scheduling options, clinical certifications, leadership development programs, and career coaching.


