Clinical Medical Review – Oncology (Underwriting) (JR192475)
About The Position
This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Medical Underwriter Sr (Clinical Review) is responsible for determining acceptability of medically underwritten risks for more complex cases. Primary duties may include, but are not limited to: Calculates appropriate group/individual premium rates for new business and renewal in accordance with Corporate Underwriting Guidelines and federal and state statutes. Proposes new business rates for complex cases ensuring rating compliance, utilizing a combination of medical applications, additional medical information, and manual rates. Calculates renewal rates for complex cases utilizing a thorough analysis of medical experience, location, demographic nature, etc. Evaluates medical information in order to assign appropriate underwriting decision. Monitors and review rating compliance reporting with actuaries for assigned business. Analyzes and responds to written and verbal underwriting inquiries. Participates in and may lead special underwriting projects. Interacts frequently with brokers and sales, administration and actuarial areas.
Requirements
- Requires a BA/BS in a related field
- Minimum 3 years of related experience
- Any combination of education and experience, which would provide an equivalent background.
Nice To Haves
- RN license strongly preferred.
- 5 years of clinical experience in Oncology setting strongly preferred.
- Clinical documentation / medical chart review experience strongly preferred.
- Utilization Management experience preferred.
Responsibilities
- Calculates appropriate group/individual premium rates for new business and renewal in accordance with Corporate Underwriting Guidelines and federal and state statutes.
- Proposes new business rates for complex cases ensuring rating compliance, utilizing a combination of medical applications, additional medical information, and manual rates.
- Calculates renewal rates for complex cases utilizing a thorough analysis of medical experience, location, demographic nature, etc.
- Evaluates medical information in order to assign appropriate underwriting decision.
- Monitors and review rating compliance reporting with actuaries for assigned business.
- Analyzes and responds to written and verbal underwriting inquiries.
- Participates in and may lead special underwriting projects.
- Interacts frequently with brokers and sales, administration and actuarial areas.
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical, dental, vision, short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
