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South Carolina’s largest and oldest health insurance company
Molecular Diagnostics Medical Director
Location
Hawaii + 3 moreAll locations: Hawaii | Massachusetts | Utah | Vermont
Posted
123 days ago
Salary
0
Seniority
Lead
Job Description
Molecular Diagnostics Medical Director
BlueCross BlueShield of South Carolina
• Provides administrative oversight to the medical staff • Analyzes medical review utilization data • Researches new medical procedures or technology • Acts as a resource to providers and internal staff on medical policies • May write and revise medical policies • Develops claim adjudication criteria • Provides input on operational policies, processes, and procedures • Educates staff and medical community on medical policy and program administration • Develops external relationships with the medical community • Reviews physician and provider practice pattern analysis and other statistical data • Conducts research into new or controversial medical procedures and technology
Job Requirements
- Doctorate degree
- Medical Doctor (MD) with current active license to practice medicine
- Active state medical license and current board certification in a recognized specialty
- Five years post graduate experience in direct patient care
- 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
- Knowledge of medical and utilization review techniques
- Experience interpreting medical evidence
- Scientific training/Research experience with publication history in Molecular Diagnostics
- Microsoft Office Suite
Benefits
- 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
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