Lead Medical Risk Consultant

This is a full-time, hybrid role where you will be expected to work in the office 2–3 days per week. Locations: Marblehead, MA; Atlanta, GA; Plano, TX; Edina, MN.

About the role

Provide consultancy advice and training to enhance knowledge of the valuation industry and property market trends across Service Delivery and Risk business units. 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.

Responsibilities

• 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.

Requirements

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

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

Pay

The starting salary for this role is between $98,500 and $162,500. The final salary offer will be based on the role’s complexity, location, and the candidate’s professional background, including education and experience.

Benefits

• 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 well-being coaching, gym membership, confidential counseling, financial and legal advice
• Tuition reimbursement for professional certifications and continuing education
• Annual discretionary bonus plan based on business and individual performance
• Employee Network and Community – QBE actively supports six Employee Networks and many ways to give back to your community