Physical Medicine and Rehabilitation Medical Director

BlueCross BlueShield of South Carolina

Medical Director providing administrative oversight and support operations in Physical Medicine and Rehabilitation. Analyzing data and promoting medical policy adherence with a focus on quality care.

Posted 6/30/2026full-timeRemote • North Carolina, South Carolina, Utah, Vermont • 🇺🇸 United StatesLead💰 $206,011 - $413,523 per yearWebsite

About the role

Key responsibilities & impact

Provides administrative oversight to medical staff
Analyzes medical review utilization data
Researches new medical procedures or technology
Acts as a resource to providers and internal staff on medical policy issues
Writes and revises medical policies
Supports operations in case review on 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 medical policy and program administration
Develops and updates medical policies in consultation with regulatory personnel and consultants
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

What you’ll need

Doctorate in a job related field
5 years post graduate experience in direct patient care
Microsoft Office
Excellent verbal and written communication skills
Excellent customer service, organizational, and presentation skills
Good judgment 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
Active state medical license and current board certification in a recognized specialty

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Medical Policy DevelopmentUtilization Review TechniquesClaim Adjudication Criteria DevelopmentStatistical Data AnalysisResearch Into Medical Procedures And Technology

Soft Skills

Excellent Verbal And Written Communication SkillsExcellent Customer Service SkillsOrganizational SkillsPresentation SkillsGood Judgment Skills

Certifications

Active State Medical LicenseCurrent Board Certification In A Recognized Specialty