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AVP, Group Insurance Regional Medical Director

Employer
Lincoln Financial Group
Location
Charlotte, North Carolina
Closing date
May 7, 2020

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Specialty
Occupational Medicine
Hours
Full Time
Position Type
Permanent

AVP, Group Insurance Regional Medical Director

Locations: Charlotte, NC or Atlanta, GA

Relocation assistance will be considered/provided for this opportunity within our company guidelines.

About the Company

Lincoln Financial Group, a Fortune 250 company with over 10,000 employees, provides advice and solutions that help empower Americans to take charge of their financial lives with confidence. Our core business areas — Life Insurance, Annuities, Retirement Plan Services and Group Protection — focus on supporting, preserving and enhancing over 17 million customer’s lifestyles and retirement outcomes.

GENERAL PURPOSE OF JOB

This role will provide leadership & direction for medical management of disability and critical illness insurance claims.  She/he will oversee contracted independent consulting physician review services, and primarily for disability and critical illness claims. S/he will also provide medical expertise & clinical support to nurse case managers, clinical research specialists, behavioral therapists, vocational rehabilitation counselors, and claims case managers, and other staff regarding diagnosis(es), level of medical impairment, restrictions and limitations on functional capacity, treatment, prognosis, and standards of care. S/he will contribute to the development of medical policy/protocols & clinical strategy, and will provide medical support to a variety of functional areas, including sales, marketing, legal & appeals in complex issues & initiatives.

DUTIES AND RESPONSIBILITIES

  • Oversees clinical aspects of contracted independent consulting physician, and nurse, behavioral therapist, and vocational rehabilitation counselor medical review services in region, in collaboration with Chief Medical Officer and other medical department staff.
  • Communicates with treating providers on behalf of Lincoln to reach consensus, where possible, on complex issues related to impairment, restrictions and limitations, treatment, and prognosis for disability and critical illness claims.
  • Provides consultative advice and expertise to clinical research specialists, nurse case managers, vocational rehabilitation counselors, behavioral therapists, and claims case managers in response to daily clinical support needs.
  • Maintains current knowledge of peer-reviewed medical literature and the standard of care to ensure the highest quality clinical decision-making possible.
  • Oversees contracting, recruiting, and quality assurance for contracted independent consulting physicians and other peer review vendors in region.
  • Collaborates with the Chief Medical Officer and other Regional Medical Directors to develop medical policies & protocols and clinical strategy in support of business objectives.
  • Collaborates with Sales & Marketing to promote Lincoln products and services and attract relationships and interest for business via a mix of direct visits and/or speaking engagements with clients/prospects in region and nationally.
  • Supports Chief Medical Officer in oversight and review of clinical content for employee training programs; participates in training of clinical and claims employees.
  • Participates in and provides medical advice expertise to various Lincoln committees and task forces relating to complex issues/initiatives.
  • 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, including corporate clients, human resources, legal departments, public affairs, and loss prevention.
  • Directs/executes approved strategy decisions and contributes to strategy creation for assigned area(s) of responsibility.
  • Provides strategic direction to build and enhance the capability for his/her assigned area(s) of responsibility.
  • Directs and enhances organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives within 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.
  • Provides subject matter expertise to team members and applicable internal/external stakeholders on complex assignments/projects for his/her assigned area(s) of responsibility.
  • 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.

EDUCATION AND EXPERIENCE

  • Medical Degree and successful completion of a residency training program recognized by the American Board of Medical Specialties or equivalent (Minimum Required)
  • 10+ years experience with workplace medical issues, STD, LTD, workers compensation, employer benefits, clinical protocols in a medical setting directly related to the specific responsibilities of this role, with at least 5 years experience in clinical practice. (Required)
    Experience in a medical management/leadership role and academic teaching are preferred

CERTIFICATIONS

  • Upon Hire: Board certification by the American Board of Medical Specialties or equivalent, in a specialty or sub-specialty relevant to adult workplace medical, surgical, or mental health conditions.
  • Upon Hire: Unrestricted Active State Licensed to practice in certified medical, surgical, or mental health specialty

TRAVEL REQUIREMENTS

  • Travel Type: National Domestic
  • Travel Amount: up to 40%

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