Molecular Diagnostics Medical Director
BlueCross BlueShield of South Carolina
full-time
Posted on:
Location Type: Remote
Location: Hawaii • Massachusetts • United States
Visit company websiteExplore more
Job Level
About the role
- 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
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical review utilization data analysisclaim adjudication criteria developmentmedical policy writing and revisionmedical evidence interpretationresearch experienceMolecular Diagnostics
Soft Skills
verbal communicationwritten communicationcustomer serviceorganizational skillspresentation skillspersuasionnegotiationinfluence
Certifications
Doctorate degreeMedical Doctor (MD)active state medical licenseboard certification in a recognized specialty