Posted on May 22, 2019 by Reliance Standard
The Medical Director provides leadership & direction for the Reliance Standard Life (RSL) Group Disability, Life and Voluntary Claim Operation. This role provides medical expertise & clinical direction to clinical nurse specialists, vocational rehabilitation specialists, and claims examiners regarding diagnosis(es), level of medical impairment, functional capacity, treatment, prognosis, and standards of care. F requent discussions with treating providers on expected durations and restrictions/limitations. They will contribute to the development of medical policy/protocols & clinical strategy while providing medical support to a variety of functional areas, including sales, marketing, legal & appeals in complex issues & initiatives.
Effectively communicates with treating providers on behalf of RSL on complex issues related to impairment, restrictions and limitations, treatment, duration and prognosis for disability and critical illness claims.
Operates in partnership to provide consultative medical advice and expertise to clinical nurse specialists, vocational rehabilitation specialists, and claims examiners in response to daily clinical support needs.
Effectively collaborates with operational leaders and clinical team to develop medical policies & protocols and clinical strategy in support of business objectives.
Develops and provides clinical content for employee training programs; participates in training of clinical and claims employees.
Oversees contracting, recruiting, and quality assurance for contracted independent consulting physicians and other clinical review vendors.
Effectively collaborates with Sales & Marketing to promote RSL's value story, products, and services. Participates in sales process with brokers, prospective and existing clients.
Leads strategic discussions with internal groups/stakeholders to develop best practices in clinical support to meet business objectives.
Serves as a medical expert for a variety of activities and stakeholders in Claims. May support other internal corporate clients including Underwriting and Actuarial.
Directs/executes approved strategy decisions and contributes to strategy creation for assigned area(s) of responsibility.
Identifies and directs strategic process improvements that significantly improve quality across the team, department and/or business unit for assigned area(s) of responsibility.
Maintains current knowledge of peer-reviewed medical literature and the standard of care to ensure the highest quality clinical decision-making possible.
Maintains knowledge on current and emerging developments/trends for assigned area(s) or responsibility, assess the impact, and collaborates with senior management to incorporate new trends and developments in current and future strategies.
Required Knowledge, Skills, Abilities and/or Related Experience:
Active Board certfication and unrestricted active State License
Medical Degree and successful completion of a certified residency training program recognized by the applicable Medical Specialty Board required.
Active Board certification by the applicable Board of Medical Specialties. If candidate has a sub specialty, successful completion of fellowship in that specialty required.
Unrestricted Active State License to practice in board certified medical, surgical, or mental health specialty required.
5 to 10 years medical practice in applicable specialty (post residency) required.
5-10 years' experience with workplace medical issues, STD, LTD, workers compensation, employer benefits, and clinical protocols in a medical setting directly related to the specific responsibilities of this role required.
Experience in a medical management/leadership role and academic teaching are preferred.
Demonstrated computer proficiency and experience with electronic medical records. Knowledge of Microsoft products required.
Demonstrated ability to describe work function as well as restrictions and limitations to multiple roles.
Demonstrated ability to work with a team in a collaborative environment.
Demonstrated ability to be productive in a fast paced environment and meet deadlines
Demonstrated ability to drive and enhance organizational initiatives through positive influencing and supporting change: within departmental/enterprise initiatives.