Lead Medical Risk Consultant

Primary Details

Time Type: Full time



Worker Type: Employee

The Opportunity: The purpose of this role is to provide consultancy advice and training to enhance knowledge of the valuation industry and property market trends across Service Delivery and Risk business units, as well as to lead risk assessments for Accident and Health (A&H) by evaluating risks, monitoring regulatory changes, and driving continuous improvement to achieve A&H risk management objectives.

• Location: Marblehead, MA, Edina, MN, and Plano, TX
• Work Arrangement: This role is hybrid, where you will be expected to be in the office 2-3 days per week
• The starting salary for this role is between $94,500 and $141,500
  
  
  
  

Your New Role

• Perform new business and renewal large claims reviews and disclosure assessments through clinical and claims data evaluation to identify and quantify risks.
• Provide concise, detailed, and accurate reporting of data analysis findings, observations, and recommendations.
• Serve as the subject matter expert for claims and underwriting related to risk management.
• Provide clinical assessment and recommendations for setting reserves on large dollar claims.
• Present in-house clinical education to enhance understanding of high-cost diagnoses and treatment trends.
• Responsible for clinical thought leadership, participating in product development and educational presentations.
• Consult with internal and external clients on high-cost, complex claims and engage in effective clinical risk management strategies.
• Review transplant contracts and vendor selections for quality control to ensure the best options.
• Build relationships with key stakeholders to communicate risk factors and develop recommendations for continuous improvement.
  
  
  
  

Required Qualifications

• Bachelor's Degree or equivalent combination of education and work experience
• Certifications as a Registered Nurse (RN)
  
  
  
  

Preferred Experience

• Strong communication skills, with ability explain and justify work product
• High attention to detail
• Strong analytical skills to spot patterns and analyze reports.
• Proficiency in Excel for sorting and reviewing data.
• Understanding of the healthcare continuum and its operations.
• Experience in case management.
• Ability to work with limited information, particularly in contexts where comprehensive data is not available
  
  
  
  

Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team.

QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to:

• Hybrid Working – a mix of working from home and in the office
• 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
• Competitive 401(k) program with company match up to 8%
• Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
• Tuition Reimbursement for professional certifications, and continuing education
• Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community
  
  
  
  

To learn more, click here: Benefits | QBE US.

Why QBE? What if you could have a positive impact – at work and in the world?



At QBE, we’re enabling a more resilient future – for our customers, communities, environment, and for our people. We’re building momentum to achieve something significant and know our people are at the center of our success.

Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we’re big enough for your ambitions, yet small enough for you to make a real impact.

Join us now, so you can be part of our success – and we can be part of yours!

https://www.linkedin.com/company/qbe-north-america/

Commitment to Diversity

QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.

Equal Employment Opportunity:

QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.

Supplementary information

Skills:

Administration Management, Analytical Thinking, Business Process Improvements, Communication, Critical Thinking, Customer Service, Decision Making, Entrepreneurship, Financial Products, Intentional collaboration, Managing performance, Process Refinement, Risk Management, Risk Management Programs, Stakeholder Management

How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.