The MolDx program recently brought on MD-PhD molecular pathologist Gabriel Bien-Willner as medical director (here). As circulated within AMP and elsewhere, MolDx (part of South Carolina BCBS) has posted a position for another medical director who is a pathologist.
BCBS job posting here. I've clipped text below the break.
Medical Director
As member of the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.
Description
•30% 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.
•30% Educates staff and medical community on various aspects of medical policy and program administration.
•20% May develop and update medical policy in consultation with appropriate regulatory personnel, medical consultants, and professional societies. Develops external relationships with the medical community and serves as liaison between these entities and the contractors.
•10% Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization.
•10% Conducts research into new or controversial medical procedures and technology.
Required Education:
Doctorate degree Medical Doctor (MD) with current active license to practice medicine.
Required Work Experience:
Five years post graduate experience in direct patient care.
Preferred Experience:
AP and CP Board-certified pathologist with experience in CPT.
Previous experience involving the PFS, CLFS, and Molecular Pathology coding and reimbursement systems.
Experience in management with commitment to maintain data systems on a daily basis.
