Lead Medical Risk Consultant / RN
Marblehead, MA  / Eden Prairie, MN  / Plano, TX  / Indianapolis, IN ...View All
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Posted 1 day ago
Job Description
Lead the execution of risk assessments for Accident and Health (A&H) within area of responsibility by conducting risk assessments and risk control evaluation, monitoring changes in regulatory requirements and communicating with managers to capitalize on opportunities for continuous improvement and drive the achievement of A&H risk management objectives.
  • Lead new business large claim review and new business disclosure assessments
  • Lead the review and assessment of renewal large claim/disclosure
  • Serve as the lead resource for claims and underwriting related to risk management of A&H claims
  • Responsible for all transplant reviews, reviewing medical necessity/experimental and coordinate with outside medical expert
  • Foster effective risk decision-making within area of responsibility by completing complex risk assessments on business unit operations, analyzing results and regularly communicating with managers to assist with risk identification and recommend and influence the adoption of plans for mitigation and loss control
  • Identify and evaluate existing risk controls by gathering and analyzing data, evaluating effectiveness of controls in relation to losses and utilizing enterprise risk management guidelines to resolve issues and determine required courses of action for enhancing control model
  • Build relationships with key stakeholders by utilizing individual credibility and applying business acumen to communicate risk factors to managers, resolve complex inquiries and develop recommendations for continuous improvement and alignment with overall A&H risk strategy
  • Utilize a comprehensive approach to risk mitigation within area of responsibility by monitoring regulatory changes to ensure on-going adherence to reporting requirements
  • Develop a long-term approach to risk mitigation by performing scenario analyses for future risks and communicating with managers to share recommendations for mitigation and loss control
  • Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility
  • Contribute to a positive environment by demonstrating cultural expectations and guiding leaders to reward performance and value "can do" people, accountability, diversity and inclusion, flexibility, continuous improvement, collaboration, creativity and fun
  • Adopt QBE values in personal work behaviors, decision-making, contributions and interpersonal interactions; manage own career development by soliciting feedback and valuing other perspectives

Number of Openings:


How to Apply:

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Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

Equal Employment Opportunity

The companies of QBE North America are committed to equal employment opportunities. All qualified applicants will receive consideration for employment without regard to age, disability, marital or parental status, national origin, citizenship, race, color, religion, sex, sexual orientation, or veteran status. All personal information contained in this application will be kept confidential as required by law.


Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
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