Clinical Account Executive
Business Insurance has recognized Lockton as one of the “Best Place to Work in Insurance” for seven years running. We think you’ll agree! A few of the reasons Associates love working at Lockton include:
•Opportunities for growth and advancement, including paid training and professional development
•12-week paid parental leave
•A huge emphasis on community involvement –Associates are encouraged to support and volunteer for their favorite charities
•Frequent athletic and wellness events
•Social and teambuilding opportunities like happy hours and other celebrations
•Incredibly generous rewards; US Associates receive a Rolex for their 10 year anniversary!
Lockton Dunning Benefits is currently seeking a Clinical Consultant within our Stop Loss Specialty Practice in Minneapolis, MN or Dallas, TX. The objective of this role is to improve to reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client’s employee health plan.
ESENTIAL DUTIES AND RESPONSIBILITIES:
•Manage and organize task lists and open items.
•Provide case oversight for Clients health plan Case Management nurses.
•Provide explanation of disease states and associated costs.
•Provide the underwriting department with cost-of-care estimates used in the risk assessment of stop loss underwriting.
•Consult with and advise underwriting on medical/clinical care approaches, standards of care and research of data for new business and renewal underwriting.
•Serve as the primary resource to claims auditors regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims.
•Initiate process improvements on an ongoing basis to generate additional claims cost containment opportunities.
•Use multiple technologies for identifying and monitoring risk identification, coaching, and guidance for individuals into appropriate health care programs.
•Coordinate implementation of claims savings solutions with Lockton service teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance.
•Review of all documents related to clients’ stop loss coverage including policies and administrative agreements to ensure accuracy and prevent gaps in coverage.
•Ability to manipulate large spreadsheets.
•Meet with Client Service Teams alone or in conjunction with other team members to review monthly a) large claims, b) abnormal utilization results, c) managed care and ongoing case management opportunities.
•Other responsibilities as required
•Licensure as a RN or Bachelor’s in Healthcare Management or related field.
•A minimum of 5 years of clinical/administrative/risk management experience
•CCM, NANCM, or other certification or designation is a plus.
•Working knowledge of or experience in quality/management/performance improvement a plus, as would be familiarity with accreditation standards and CMS regulations.
•Proven project management experience.
•Strong organizational skills with ability to handle multiple tasks, in a fast paced environment. Excellent oral and written communication skills.
Lockton Companies, LLC is an equal opportunity employer. As a privately held company, we offer a competitive compensation and benefits package reflecting our commitment to attracting and retaining great individuals. This includes health and dental coverage, which begins on your first day of work, 401(k) with match and immediate vesting, a competitive vacation plan and unrivaled career advancement opportunities.
More than 5,600 professionals at Lockton provide 48,000 clients around the world with risk management, insurance, employee benefits consulting, and retirement services that improve their businesses. From its founding in 1966 in Kansas City, Missouri, Lockton has attracted entrepreneurial professionals who have driven its growth to become the largest privately held, independent insurance broker in the world and 10th largest overall. For seven consecutive years, Business Insurance magazine has recognized Lockton as a " Best Place to Work in Insurance ." To see the latest insights from Lockton’s experts, check Lockton Market Update.
Lockton is known throughout the insurance industry as an entrepreneurial, progressive and successful insurance broker. As a result of continued individual and group accomplishments, Lockton has a record of steady and substantial growth. If you are a committed professional with a passion for delivering unparalleled service, Lockton is interested in hearing from you.
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