Physical Medicine and Rehabilitation Medical Director

BlueCross BlueShield of South Carolina

Medical Director overseeing rehabilitation case review, utilization data, and medical policy for BlueCross’s government healthcare contracts. Advising providers, staff, and contractors on medical procedures and regulatory matters.

Posted 8/5/2026full-timeColumbia • Hawaii, South Carolina, Utah, Vermont • 🇺🇸 United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical policy development, case review, and operational oversight while effectively communicating with medical staff and the community. Possesses strong judgment and negotiation skills, supported by a Doctorate and extensive experience in patient care.

Highest-signal resume keywords

Doctorate In A Job Related Field5 Years Post Graduate Experience In Direct Patient CareActive State Medical LicenseCurrent Board Certification In A Recognized SpecialtyKnowledge Of Medical And Utilization Review Techniques

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Policy DevelopmentCase ReviewClaim Adjudication CriteriaStatistical Data AnalysisResearch Into Medical ProceduresMicrosoft Office ProficiencyMedical JudgmentUtilization Review Techniques

Soft Skills

Excellent Verbal And Written Communication SkillsExcellent Customer Service SkillsOrganizational SkillsPresentation SkillsGood Judgment SkillsAbility To Persuade, Negotiate, Or Influence OthersTeam Leadership

Certifications & Qualifications

Current Board Certification In A Recognized Specialty

Industry Keywords

Medical Staff OversightOperational PoliciesMedical Community LiaisonPractice Pattern AnalysisSecurity Clearance

About the role

Key responsibilities & impact

Provides administrative oversight to the medical staff
Supports operations through case review on medical and regulatory matters
Develops claim adjudication criteria for situations requiring medical judgment
Provides input on operational policies, processes, and procedures
Educates staff and the medical community on medical policy and program administration
Develops and updates medical policy in consultation with regulatory personnel, medical consultants, and professional societies
Develops external relationships with the medical community and serves as liaison between these entities and contractors
Reviews physician and provider practice pattern analysis and statistical data related to unusual medical service utilization
Conducts research into new or controversial medical procedures and technology
May write and revise medical policies

Requirements

What you’ll need

Doctorate in a job related field
5 years post graduate experience in direct patient care
Microsoft Office proficiency
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
Current board certification in a recognized specialty
Ability to obtain a security clearance
U.S. Citizen required for security clearance
Position is not eligible for sponsorship now or in the future

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