Clinical Advisor
Philadelphia, Pennsylvania, United States of America
Client Services
2401XD
Working at Lockton
At Lockton, we’re passionate about helping our people achieve their ultimate potential. Our people are curious, action-oriented and always striving to make ourselves and those around us better. We’re active listeners working to ensure understanding and problem solvers developing innovative solutions. If you can see yourself delivering excellent service to clients, giving back to our communities and being a part of our caring culture, you belong here.
Texas
Business unit
Lockton-Dunning Series
Salary
$0-$0
Schedule
Full-time
Job type
Standard
Workplace
Hybrid
Your Responsibilities
Lockton People Solutions is currently seeking a Clinical Advisor within our Specialty Practices clinical advisory services. The objective of this role is to be the main contact and act as a conduit between Lockton’s regional offices and the clinical team. This is a client facing role which includes validating clinical reporting and assisting with complex cases to improve to a member’s quality of care while reducing spend.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES
• Act as a liaison to Lockton’s regional offices and a clinical resource and subject matter expert for various specialty practices.
• Utilize market knowledge to respond to and present Lockton’s position on emerging clinical innovations and trends and the clinical impact to employer benefit plans and employee populations.
• Present clinical practice service capabilities and value proposition to both current and prospective clients, including senior leaders, as well as internal sales leads, and clients service teams.
• Collaborate with various key stakeholders to develop series specific clinical and cost savings strategies and assist on execution of plan.
• Actively participate in client strategy meetings to discuss high-cost member trends and outlook and associated cost containment impacts and opportunities.
• Interpret and articulate clinical findings to tell the story of the member’s health care journey and the impact of cost savings strategies.
• Explain disease states and associated costs to internal teams and external clients.
• Validate cost-of-care estimates used in the risk assessment of stop loss underwriting.
• Advise on medical/clinical care approaches, standards of care and research of data for new business and renewals.
• Serve as a subject matter expert regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims.
• Review escalated and complex cases to identify and monitor opportunities to increase member quality of care and overall cost reduction.
• Participate in clinical rounds to discuss cases and strategy solutions.
• Comply with HIPAA Standards and protect the confidentiality of data.
Qualifications
EDUCATION, EXPERIENCE, AND SKILLS REQUIRED
• Licensure as a RN or bachelor’s in healthcare management or related field
• 5-7 years of clinical/risk management experience
• 5 years’ experience in health insurance industry
• 2 years of claims and/or utilization review experience a plus
• Deep market knowledge with understanding of real-world clinical implications on employer benefit plans
• Demonstrated capability to deliver messages with confidence and authority in a client-facing role
• Strong organizational skills with ability to handle multiple competing priorities in a fast-paced environment
• Excellent oral and written communication including presentation to various levels of leadership audiences
• Willing to travel for client and internal meetings as necessary
• Legally able to work in the United States
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.
This posting has been anticipated to close on 01-02-2025. Submit your application by clicking on the Apply Now button.
Equal Opportunity Statement
Lockton Companies is proud to provide everyone an equal opportunity to grow and advance. We are committed to an inclusive culture and environment where our people, clients and communities are treated with respect and dignity.
At Lockton, supporting diversity, equity and inclusion is ingrained in our values, and we believe that we are at our best when we fully embrace everyone. We strive to cultivate a caring culture that learns from, celebrates and thrives because of our breadth of differences. As such, we recognize that recruiting, developing and retaining people with diverse backgrounds and experiences is vital and enabling our people to thrive personally and professionally is critical to our long-term success.
About Lockton
Lockton is the largest privately held independent insurance brokerage in the world. Since 1966, our independence has allowed us to serve our clients, take care of our people and give back to our communities. As such, our 10,000+ Associates doing business in over 100 countries are empowered to do what’s right every day.
At Lockton, we believe in the power of all people. You belong at Lockton.
How We Will Support You
At Lockton, we empower you to be true to yourself in all that you do. Your success is our success, and we provide opportunities to help you grow and create a rewarding career path, however you envision it.
We are ready to meet you where you are today, and as your needs change over time. In addition to industry-leading health insurance, we offer additional options to support your overall health and wellbeing.
No Agencies Please
Any Employment Agency, person or entity that submits an unsolicited resume to this site does so with the understanding that the applicant's resume will become the property of Lockton Companies, Inc. Lockton Companies will have the right to hire that applicant at its discretion and without any fee owed to the submitting Employment Agency, person or entity. Employment Agencies, who have fee Agreements with Lockton Companies must submit applicants to the designated Lockton Companies Employment Coordinator to be eligible for placement fees.
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