Medical Risk Manager – Remote

Symetra has an exciting opportunity to join our team as a Medical Risk Manager !

About The Role

In this role you will manage a team of registered nurses (Medical Risk Consultants, "MRCs"), oversee strategic planning, workflows, procedures, policies, and resources. You will develop and provide training, coaching, and mentoring of new and current MRC staff. In addition, you will monitor employee performance, professional goals, and engagement on an ongoing basis.

What You Will Do

• Team Management:
• Supervise quality controls, workflows, and procedures to ensure timely, accurate and effective handling of potential claim notices, claim cost containment opportunities, MRC case strategic direction and MRC underwriting support on new and renewal business.
• Maintain employee work schedules including assignments, flex time, vacations, telecommuting and absenteeism coverage.
• Develop and provide training, coaching, and mentoring of new and current MRC staff.
• Ongoing assessment and development of training plans.
• Deliver resources for optimizing team and individual performance including continuing education opportunities.
• Provide frequent effective performance feedback.
• Maintain a team environment and employee engagement to increase empowerment, accountability, and outstanding customer service.
• Manage the team's capacity to meet customer demand while constantly seeking to improve quality and productivity.
• Customer Service Strategy:
• Build and maintain a positive relationship with internal and external customers.
• Manage the preparation and maintenance of reports vital to the functions of the department and share with management as requested.
• Oversee, periodically test, and update the department’s Business Continuity Plan (“BCP”).
• Ensure compliance with organization policies and procedures, the Affordable Care Act (“ACA”) and other regulatory and industry standards.
• Execute budget quarterly forecasts and annual planning. Consistently perform analysis to ensure expenses are kept to a minimum and within planned budget.
• Cost-containment: Handle vendor relationships, claim notices, and cost containment.
• Stop Loss Team Support: provide expertise and support to the Stop Loss team during peak and non-peak business cycles, to include completion of underwriting reviews, underwriting projection audits, stop loss claim reviews, claim audits/second approvals, and review of complex claims.
  

Why Work at Symetra

Here’s what some of our employees have to say about why they work at Symetra:

“If you're looking for a place to call home, grow professionally and personally and most importantly, be yourself, Symetra is the right fit.” Daniel P. - Senior Underwriter

“The atmosphere at Symetra is truly different than at other companies. If you are looking for a company where your voice will matter and be heard, Symetra is the place for you.” Sydney S. - Actuarial Associate II

What We Offer You

Benefits and Perks

We don’t take a “one-size-fits-all” approach when it comes to our employees. Our programs are designed to make your life better both at work and at home.

• Flexible full-time or hybrid telecommuting arrangements
• Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%
• Paid time away including vacation and sick time, flex days and ten paid holidays
• Give back to your community and double your impact through our company matching
• Want more details? Check out our Symetra Benefits Overview
  
  

Compensation

Salary Range: $91,200-$151,900 plus eligibility for annual bonus program

Who You Are

• Bachelor’s degree in business administration, health management, or other relevant insurance/business field required.
• Active RN License required.
• 5 to 7 years of stop loss risk management experience required.
• In-depth understanding of the "self-funded insurance industry", ERISA, medical terminology, catastrophic claims management and the Affordable Care Act required.
• Stop-loss, Third Party Administrator and/or Reinsurance claims management experience preferred.
• Active role in industry associations such as SIIA (Self Insurance Institute of America) and SPBA (Society of Professional Benefit Administrators) preferred.
• Health Insurance Industry designations, such as LOMA, HIAA, ICA, etc. preferred
• Adept training and employee-development skills.
• Proven management experience including independent planning, organizing, and budgeting.
• Proven ability to develop strategy for large organization with a strong track record of successful execution.
• Demonstrated experience managing, developing, and overseeing cost-containment vendor relationships.
• Technology savvy with MS Office Suite proficiency.
• David Young ESL experience preferred.
• Outstanding customer service and interpersonal skills.
• Consistent and sound business decision-making.
• Strong research, analytical, and problem-solving.
• Excellent communication (verbal, written and presentation skills).
• Some travel required.
  
  

Travel

• Required Training & Professional Development All newly hired people leaders with direct reports are required to complete a comprehensive leadership development program within their first year. This program includes both virtual and in-person training. The in-person sessions will take place at Symetra’s corporate headquarters in Bellevue, Washington. Symetra covers all travel and accommodation expenses.
• Reasonable Accommodations Symetra is committed to providing equitable access to all job-related responsibilities, including required travel. If reasonable accommodations are needed for travel, Symetra’s HR department will work to provide appropriate solutions in alignment with individual needs and company policies.
  
  

We empower inclusion

At Symetra, we aspire to be the most inclusive insurance company in the country. We’re building a place where every employee feels valued, respected, and has opportunities to contribute.

Inclusion is about recognizing our assumptions, considering multiple perspective, and removing barriers. We accept and celebrate diverse experiences, identities, and perspectives, because lifting each other up fuels thought and builds a stronger, more innovative company. We invite you to learn more about our efforts here .

Creating a world where more people have access to financial freedom

Symetra is a national financial services company dedicated to helping people achieve their financial goals and feel confident about the future. In our daily work, we’re guided by the principles of Value, Transparency and Sustainability. This means we provide products and services people need at a competitive price, we communicate clearly and openly so people understand what they’re buying, and we design products—and operate our company—to stand the test of time. We’re committed to showing up for our communities, lifting up our employees, and standing up for diversity, equity and inclusion (DEI). Join our team and help us create a world where more people have access to financial freedom.

For more information about our careers visit: https://symetra.eightfold.ai/careers

Work Authorization

Employer work visa sponsorship and support are not provided for this role. Applicants must be currently authorized to work in the United States at hire and must maintain authorization to work in the United States throughout their employment with our company.

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