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Palmetto GBA

Physical Medicine and Rehabilitation Medical Director

Palmetto GBA

Medical Director providing administrative oversight and resource guidance in a healthcare setting. Analyzing medical data and researching new procedures while maintaining relationships with providers.

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 the medical staff
  • Analyzes medical review utilization data
  • Researches new medical procedures or technology
  • Acts as a resource to providers and internal staff on issues concerning medical policies
  • 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
  • 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 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

Requirements

What you’ll need
  • Doctorate in a job related field
  • 5 years post graduate experience in direct patient care
  • 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