Medical Doctor Job – Remote MD Role at BlueCross South Carolina | Apply
If you are searching for a high-impact medical doctor job, this remote opportunity with BlueCross BlueShield of South Carolina offers a dynamic leadership pathway. This MD Job within Palmetto GBA focuses on molecular diagnostics, Medicare policy oversight, and medical staff leadership. As part of BlueCross BlueShield of South Carolina careers, this role provides experienced physicians the chance to shape coverage decisions and influence healthcare policy at a national level.
Job Details:
- Job Title: Molecular Diagnostics Medicare Medical Director – Palmetto GBA
- Location: Remote (Available in W@H Massachusetts, W@H Georgia, W@H Vermont, W@H Hawaii, W@H Utah, and all 50 locations)
- Type: Full-time
- End Date to Apply: February 28, 2026
- Job Requisition ID: R1048417
About the Company:
BlueCross BlueShield of South Carolina is a trusted healthcare insurance leader dedicated to advancing quality care and improving patient outcomes. Through Palmetto GBA, the organization plays a critical role in Medicare administration, medical policy development, and provider engagement. BlueCross BlueShield of South Carolina careers offer physicians meaningful non-clinical pathways where an MD Job can influence healthcare systems, policy decisions, and innovation in molecular diagnostics.
Job Description:
Location: This position is full-time (40 hours/week), Monday-Friday. This position can be worked remotely.
Position Purpose: The Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees medical staff, analyzes utilization data, researches emerging molecular technologies, and serves as a resource for providers and internal teams on policy issues. The role also includes developing, writing, and revising medical policies to ensure compliance and support Medicare coverage decisions.
Qualifications:
- Required Education: Doctorate degree, Medical Doctor (MD) with a current active license to practice medicine.
- Required License and Certificate: Active state medical license and current board certification in a recognized specialty.
- Required Work Experience: Five years post graduate experience in direct patient care.
- Required Skills and Abilities: 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. Ability to work as a team member as well as a leader. Knowledge of medical and utilization review techniques.
- Required Software: Microsoft Office Suite.
Preferred Qualifications:
- Molecular Genetic Pathology fellowship training.
- Medicare experience.
- Experience interpreting medical evidence.
- Scientific training/Research experience with a publication history in Molecular Diagnostics.
Key Responsibilities:
- Support operations in the form of case review on both medical and regulatory matters.
- Develop claim adjudication criteria for situations requiring medical judgment.
- Provide input on issues and operational policies, processes, and procedures.
- Educate staff and the medical community on various aspects of medical policy and program administration.
- May develop and update medical policy in consultation with appropriate regulatory personnel, medical consultants, and professional societies.
- Develop external relationships with the medical community and serve as a liaison between these entities and the contractors.
- Review physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization.
- Conduct research into new or controversial medical procedures and technology.
Comprehensive Benefits Packages:
- 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.
