医疗顾问
Medical Consultant
职位机会
作为医疗顾问，你将作为机构的医疗领域专家，为高度复杂的核保案例提供咨询支持。你将与核保人员和医疗人员合作，评估复杂的医疗风险，并提供及时、基于证据的指导，以支持稳健的商业决策和卓越的客户结果。
此职位提供了通过教育、培训和关键医疗项目的领导来影响整个企业核保实践的机会。你将在推进医疗风险评估实践、提高决策一致性以及确保医疗指南反映当前临床知识和保险医学发展趋势方面发挥关键作用。
团队介绍
这个高度专业化的医疗核保团队提供医疗专业知识，支持风险评估和核保指南及医疗流程的持续改进。团队重视协作、知识共享、职业发展，并致力于为客户提供高质量的结果和业务成果。
职位影响
在此职位中，你将：
- 评估最复杂和医学挑战性的人寿保险核保和残疾索赔转介，提供专家咨询，以支持准确和及时的风险评估决策。
- 审阅、解读和评估主治医师声明（APS）、医疗记录、实验室结果、诊断研究和专科报告，以识别相关的死亡率和发病率风险。
- 阅读和解读心电图（EKG/ECG）结果和其他诊断测试，以支持核保和索赔评估。
- 通过案例讨论、医疗转介和指导，为核保人员、索赔审核员和其他业务合作伙伴提供持续的教育和医疗咨询。
- 领导并参与核保医疗手册、指南和参考资料的开发、审查、维护和提升，以确保与当前医学证据和保险医学最佳实践保持一致。
- 保持对医学文献、临床进展、治疗创新和与保险医学和风险评估相关的新兴趋势的专家级了解。
最低要求
- 护理学科学士学位
- 持有以下之一的有效执照：注册护士（RN）、护士执业者（NP）、高级执业注册护士（APRN）、医师助理（PA）
- 在医疗、护理或相关领域具有7年以上临床医疗经验
查看英文原文
The Opportunity
As a Medical Consultant, you will serve as one of the organization's medical subject matter experts, providing consultative support on highly complex underwriting cases. You will partner with underwriters and medical staff to evaluate sophisticated medical risks and deliver timely, evidence-based guidance that supports sound business decisions and exceptional customer outcomes.
This role offers the opportunity to influence underwriting practices across the enterprise through education, training, and leadership of key medical initiatives. You will play a critical role in advancing medical risk assessment practices, enhancing consistency in decision-making, and ensuring medical guidelines reflect current clinical knowledge and emerging trends in insurance medicine.
The Team
This highly specialized Medical Underwriting team provides medical expertise that supports risk assessment and continuous improvement of underwriting guidelines and medical protocols. The team values collaboration, knowledge sharing, professional development, and a commitment to delivering high-quality outcomes for customers and the business.
The Impact
In this role, you will:
- Evaluate the most complex and medically challenging individual life insurance underwriting and disability claims referrals, providing expert consultation that supports accurate and timely risk assessment decisions.
- Review, interpret, and evaluate attending physician statements (APS), medical records, laboratory results, diagnostic studies, and specialist reports to identify relevant mortality and morbidity risks.
- Read and interpret EKG/ECG results and other diagnostic testing to support underwriting and claims assessments.
- Provide ongoing education and medical consultation to underwriters, claims examiners, and other business partners through case discussions, medical referrals, and coaching.
- Lead and contribute to the development, review, maintenance, and enhancement of underwriting medical manuals, guidelines, and reference materials to ensure alignment with current medical evidence and insurance medicine best practices.
- Maintain expert-level knowledge of medical literature, clinical developments, treatment advances, and emerging trends relevant to insurance medicine and risk assessment.
The Minimum Qualifications
- Bachelor of Science in Nursing
- Active licenses in one of the following: RN, NP, APRN, PA
- 7+ years of clinical healthcare experience in a medical, nursing, or advanced practice setting
- 7+ years of experience reviewing and interpreting medical records, physician documentation, laboratory reports, and diagnostic testing
- 1+ year experience interpreting EKG/ECG findings within a clinical or insurance medical setting
The Ideal Qualifications
- 10+ years of experience in insurance medicine, life underwriting, disability claims, or related medical risk assessment functions
- 3+ years experience supporting life insurance underwriting, disability insurance claims, insurance medicine, occupational medicine, utilization review, case management, or a comparable medical risk assessment function
- Advanced clinical credential such as APRN, NP, CNS, PA-C, MD, or DO
- Certification in Insurance Medicine (e.g., ALU, FALU, FLMI, CLU, or equivalent insurance-related designation)
- Experience developing underwriting guidelines, medical manuals, or clinical decision-support tools
- Experience designing and delivering training programs for underwriting, claims, or medical professionals
- Bilingual proficiency in Spanish and/or Mandarin
- Demonstrated expertise in mortality and morbidity risk assessment within life insurance, disability insurance, or related financial services environments
- Experience leading cross-functional initiatives and influencing business partners on medical risk strategy
- Strong written and verbal communication skills
What You Can Expect at MassMutual
MassMutual offers the opportunity to do meaningful work within a purpose-driven organization that values long-term impact over short-term outcomes. In this role, you can expect:
- Clear areas of ownership and accountability, with work that connects directly to company and customer outcomes
- A collaborative environment where perspectives are welcomed
- Access to learning, development, and internal networks that support continuous growth and skill-building over time
- Employee-led communities and forums that foster connection, learning, and inclusion across the organization
- A culture grounded in integrity, responsibility, and stewardship—supported by a company with a strong legacy and a future-focused mindset
Salary Range:
$107,700-$141,300
At MassMutual, we focus on ensuring fair equitable pay, by providing competitive salaries, along with incentive and bonus opportunities for all employees. Your total compensation package includes either a bonus target or in a sales-focused role a Variable Incentive Compensation component.
Why Join Us.
We’ve been around since 1851. During our history, we’ve learned a few things about making sure our customers are our top priority. In order to meet and exceed their expectations, we must have the best people providing the best thinking, products and services. To accomplish this, we celebrate an inclusive, vibrant and diverse culture that encourages growth, openness and opportunities for everyone. A career with MassMutual means you will be part of a strong, stable and ethical business with industry leading pay and benefits. And your voice will always be heard.
We help people secure their future and protect the ones they love. As a company owned by our policyowners, we are defined by mutuality and our vision to put customers first. It’s more than our company structure – it’s our way of life. We are a company of people protecting people. Our company exists because people are willing to share risk and resources, and rely on each other when it counts. At MassMutual, we Live Mutual.
MassMutual is an equal employment opportunity employer. We welcome all persons to apply.
If you need an accommodation to complete the application process, please contact us and share the specifics of the assistance you need.
At MassMutual, we focus on ensuring fair, equitable pay by providing competitive salaries, along with incentive and bonus opportunities for all employees. Your total compensation package includes either a bonus target or in a sales-focused role a Variable Incentive Compensation component. For more information about our extensive benefits offerings please check out our Total Rewards at a Glance.
Originally posted on Himalayas