Clinical Underwriting Consultant

April 8

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Voya Financial

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Voya Financial is a leading financial services company that provides a wide range of retirement, investment, and insurance products to help individuals, families, and institutions plan, invest, and protect their future. With a focus on retirement savings and workplace benefits, Voya connects benefits and savings to simplify financial experiences and enhance financial security. The company is committed to making a positive difference by serving others through its unique culture, and has been recognized for its values and customer-centric approach. Voya also engages in initiatives like the Voya Behavioral Finance Institute for Innovation to further its mission of transforming financial care in the workplace.

Retirement • Investments • Insurance

5001 - 10000 employees

Founded 1998

💸 Finance

📋 Description

• Favorably impact Stop Loss risk profile through early identification of potential high cost patients. • Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the severity of medical conditions, and estimate the duration of treatment and expected future costs. • Researches clinical conditions and provides analytical review of the medical and/or pharmacy data to formulate the history of events. • Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data. • Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision. • Works collaboratively with the cost containment team ensure a proper hand off of potential high cost patients. • Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate Cost Containment specialty teams to address these identified risks.

🎯 Requirements

• Bachelor’s degree - current unrestricted RN license, or equivalent clinical degree • Minimum 5 years of clinical experience • Minimum 2 years insurance experience • Analytical and problem solving skills • Excellent interpersonal and negotiation skills to act as a company representative • Experience in Microsoft Office products

🏖️ Benefits

• Health, dental, vision and life insurance plans • 401(k) Savings plan – with generous company matching contributions (up to 6%) • Voya Retirement Plan – employer paid cash balance retirement plan (4%) • Tuition reimbursement up to $5,250/year • Paid time off – including 20 days paid time off, nine paid company holidays and a flexible Diversity Celebration Day. • Paid volunteer time — 40 hours per calendar year