Clinical Medical Review – Oncology

Role Overview

• Determines acceptability of medically underwritten risks for complex cases
• Calculates appropriate group/individual premium rates for new business and renewal
• Proposes new business rates for complex cases ensuring rating compliance
• Calculates renewal rates for complex cases utilizing a thorough analysis of medical experience
• Evaluates medical information to assign appropriate underwriting decision
• Monitors 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, sales, administration and actuarial areas

Requirements

• Requires a BA/BS in a related field
• Minimum 3 years of related experience
• 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

Benefits

• Comprehensive benefits package
• Paid Time Off
• 401(k) contribution
• Incentive and recognition programs
• Stock purchase plan
• Medical, dental, and vision benefits
• Short and long term disability benefits
• Wellness programs
• Financial education resources