VP & Medical Director

WHAT WE CAN OFFER YOU:

• Estimated Salary: $201,000 - $320,000, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time and paid holidays. See our benefits and perks page for details.
• Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. 

WHAT YOU'LL DO:

• Strategic Leadership: Plan, lead, and control activities in medical review, underwriting, and claims, including project planning, budget management, and training.
• Budget Administration: Work within the department's budget for cost-effective operations, including planning projects and capital budgets.
• Planning and Coordination: Partner with operational Claims and Clinical/Vocational teams to manage work volumes, and prioritization of work with a focus on delivering timely service and opinions on our customer's claims.
• Medical Oversight: Provide professional oversight for medical review, utilization analysis, and claim review. Conduct reviews and ensure compliance with medical standards.
• Policy Formulation: Formulate policies and procedures for medical reviews of claims. Increase effectiveness, make accurate decisions, and address fraud, waste, and abuse.
• Continuous Improvement: Evaluate and revise medical management processes and provide input on claims guidelines.
• Collaboration and Representation: Maintain business relationships with medical staff directors, participate in joint meetings, provide cross-coverage assistance where appropriate, and represent the company at national and regional medical director meetings.

WHAT YOU’LL BRING:

• You hold a medical degree with an unrestricted license, appropriate board certification, and bring seasoned clinical experience to the table.
• Demonstrate hands-on experience in claims review, emphasizing a deep understanding of insurance processes and industry dynamics.
• Possess background and experience in Internal Medicine, Family Medicine, or Primary Care settings, showcasing a diverse and comprehensive medical skill set.
• Showcase effective organizational, planning, analytical, and management skills, ensuring a strategic and streamlined approach to medical operations.
• Excel in strong negotiation, communication, and human relations skills, fostering collaborative relationships and effective communication across diverse stakeholders.
• You promote a collaborative culture, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

PREFERRED:

• 5 years’ experience working with Disability Claims

We value unique experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply! 

If you have questions about your application or the hiring process, email our Talent Acquisition area at careers@mutualofomaha.com. Please allow at least one week from time of applying if you are checking on the status.

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