Vice President & Medical Director - Group Insurance (Remote)

3+ months agoWest Caldwell, NJ

Our Business

For more than 140 years, Prudential Financial has provided individual and institutional customers with financial opportunities. A financial services leader with more than $1 trillion of assets under management as of June 30, 2018, Prudential has operations in the United States, Asia, Europe and Latin America. We provide customers with a variety of financial products and services, including disability and absence insurance, life insurance, annuities, retirement-related services, mutual funds and investment management.

How we conduct our business is just as important as what we do. Our core values are the principles that guide us daily in helping our customers achieve financial prosperity and peace of mind. At all times, we strive to distinguish Prudential as an admired multinational financial services leader and trusted brand that is differentiated by top talent and innovative solutions for all stages of life.

This is an exciting opportunity to be a part of Prudential's Group Insurance organization, which sits within our broader Workplace Solutions organization. In this role you will join a team of medical professionals helping claims staff and clinicians review complex medical claims to determine functional capacity and support business success.

The Role

As a VP & Medical Director based in Roseland, NJ, Scottsdale, AZ, Portland, ME or virtual (with appropriate experience), you will:

  • Provide leadership and insight to clinicians as well as the claims organization
  • Partner with claims & clinical professionals to conduct claim discussions on complex short- and long-term disability claims
  • Perform comprehensive file reviews, assessing risk, determining capacity to work, limitations and restrictions
  • Outreach to treating providers, as needed
  • Summarize claim review findings in a comprehensive, written report
  • Ensure the confidentiality of personal health information by following legal and departmental requirements
  • Provide subject matter expertise to all areas within Group Insurance, as needed
  • Participate in project work streams based on business needs
  • Partner with external peer review vendors, as needed for quality discussions
  • Plan, organize and implement educational initiatives and support to clinicians, claims professionals and leadership

Offering the opportunity to work remotely or, if nearby, from a Prudential Group Insurance location.

Your Expertise
What you'll need to succeed:
  • Licensed MD, DO, PsyD or PhD in the state in which you live
  • Board certification in at least one of the following: Psychiatry, Psychology, Neuropsychology, OccMed, Neurology or PM&R
  • At least 5 years of active clinical experience, excluding residency
  • Ability to work independently in a fast-paced work environment and set day to day work priorities
  • Comfortable working in a matrix environment with a focus on teamwork in a corporate setting
  • Excellent verbal and written communication
  • Exceptional leadership skills
  • Proficiency in Microsoft suite and ease of learning new technology

    It'd be a plus if you have:
  • Aptitude in reviewing disability claims to determine impairment, restrictions, limitations
  • Familiarity with workplace accommodations
  • Comfortable with doctor to doctor calls
  • Ability to travel, as needed, based on business needs (<25>

Job ID: Prudential-DIS000CH

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