Associate Director, Clinical Services

Sun LifePortland, OR
Hybrid

About The Position

The Associate Director, Clinical Services leads a staff of Registered Professional Nurses (RN’s) and Clinical Underwriting Team to ensure accurate and timely clinical reviews in conjunction with an eye to assure optimization of health, risk mitigation, and support of our internal and external clients in understanding of disease processes and the potential treatment needs of the same. Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

Requirements

  • Ability to work with a diverse range of people.
  • Experience Registered Nurse (RN) with 3-5 years’ experience in Stop Loss or similar financial/insurance field.
  • Experience in Clinical UW for Stop Loss or similar financial or health products.
  • Registered Nurse in Good standing
  • High level of medical expertise and business knowledge of claims risk management
  • Demonstrated ability to coach and develop others
  • Able to solve problems that don’t have clear solutions or outcomes
  • Strong analytical and critical thinking skills
  • Strong project management and organizational skills
  • Collaborative and comfortable in cross functional organizations
  • Excellent communication skills

Nice To Haves

  • additional certifications a plus

Responsibilities

  • Provide accurate and timely consultation on referrals from the Underwriting team and other internal clients
  • Identify members who could benefit from additional resources like Clinical 360 cost containment measures
  • Optimize both risk and health outcomes
  • Conduct regular Quality Assurance (QA) reviews and provide coaching
  • Set performance goals and conduct reviews using appropriate tools
  • Offer career development and training opportunities
  • Make key personnel decisions (hiring, terminations, promotions, salary increases)
  • Support staff in identifying and implementing innovative solutions
  • Build collaborative relationships within the Underwriting organization
  • Facilitate partnerships across the broader Health and Risk solutions claims organization
  • Contribute to special projects and change management activities
  • Promote the company's philosophy, strategies, and business objectives
  • Develop an interdisciplinary clinical model aligned with business needs
  • Manage operating expenses within budget

Benefits

  • generous vacation and sick time
  • market-leading paid family, parental and adoption leave
  • medical coverage
  • company paid life and AD&D insurance
  • disability programs
  • partially paid sabbatical program
  • 401(k) employer match
  • stock purchase options
  • employer-funded retirement account
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