Medical Specialist, RN - Insurance
Location: Beverly, Massachusetts
Description: Liberty Mutual is at present looking to employ Medical Specialist, RN - Insurance right now, this job will be dwelled in Massachusetts. Detailed specification about this job opportunity please read the description below. Advance your nursing/case management experience at TRU a Liberty Mutual Company.
If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, TRU has the opportunity for you. This position requires collaborating with physicians, other medical providers, employers, and claims professionals by providing nurse case management services. This position will work from the Beverly, MA office with remote possibility.
Under limited technical direction, responsible for managing assigned case load and by applying clinical expertise to assess risk on an individual and group basis on medical stop loss coverage in a timely and effective manner. Caseload includes catastrophic, complex medical only claims. Also acts as a clinical resource for risk management, claim and underwriting partners.
Case management is in liaison with insurance and clinical professionals; there is no patient contact. Responsibilities:
Follows Liberty Mutual's established standards and protocols to effectively manage assigned case load; and by applying clinical expertise to assess current and ongoing risk assessment.
Effectively communicates with claims administrators, brokers, medical professionals, risk management, claims and underwriting staff and others to obtain information, and assists with cost containment negotiations using critical thinking skills, clinical expertise and other resources as needed to assess and clearly document and support risk assessments.
Appropriately utilizes internal and external resources and referrals i.e., David Young System (DYS), AMS PredictDX / RX, to communicate and support assessment.
Independently handles assigned caseload. Follows limited technical direction from manager to resolve highly complex medical and/or successfully manage catastrophic claim assessments.
Provides technical and clinical direction and resource to risk management, claims, ProAct and underwriting staff.
Ability to document in narrative form all RN activities (tasks) accurately, concisely and on a timely basis. This includes documenting reserves, lasers, new / renewal business risk management assessments, based on clinical expertise. Adheres to confidentiality policy.
Appropriately applies clinical expertise to risk assessment process and delivers services in an efficient and effective manner. Handles special projects as assigned.
Participates in customer or prospect meetings or special projects as needed
Qualifications:
Current unrestricted registered nurse (R.N.) license.
Degree from an accredited nursing school required. Bachelor of Science in Nursing preferred
Minimum of 3 to 5 years of clinical nursing experience; case management experience would be beneficial.
Ability to analyze, apply clinical expertise and make sound risk assessments on medical stop loss coverage, including accurately documenting and supporting recommendations and assessing medical severity.
Strong leadership and communication skills, both verbal and written, and excellent organizational skills, are required.
Knowledge of stop loss coverage concepts and plan document language is necessary.
Position includes occasional travel to industry conferences and clients.
Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (especially Excel and ppt) preferred.
Benefits:
We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please click here .
Overview:
At Liberty Mutual, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense of humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.
We’re dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Liberty Mutual.
Job:
Nursing & Medical
Primary Location: United States-Massachusetts-Beverly
Schedule: Full-time
Salary: $79,000-$100,000
Education Level: Associate's Degree/College Diploma (±13 years)
Travel: Yes, 10 % of the Time
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If you were eligible to this job, please deliver us your resume, with salary requirements and a resume to Liberty Mutual.
Interested on this job, just click on the Apply button, you will be redirected to the official website
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This job will be started on: Mon, 01 Jan 2018 15:54:05 GMT