At the direction of the Supervisor, Quality & Training, assists in the overall clinical quality and clinical standards in LTCG’s case underwriting area. Performs random on-going quality audits for the underwriting staff, identifies and assists with training needs, clinical criteria review and external audits.
- Complete regular underwriting decision quality audits for all clients as well as internal ad hoc audits. Provides written feedback to the underwriter and supervisor as indicated. Provides quality feedback to underwriting leadership at the time of performance appraisals for exempt level underwriting staff. Provides written quality audit summaries, reporting to clients as required by contract language (weekly, monthly or quarterly) and participates in client discussions regarding quality and audits.
- Assist to identify training needs, develop teaching materials, and provide training to clinical staff based on the quality review, changes in clinical practice, on-going education needs, or new staff.
- May assist with case consults for all levels of underwriters either verbally or written
- Using clinical knowledge and underwriting expertise, assists with best practice and criteria manual reviews making recommendations for changes as indicated
- Assists to update and maintain:
- PHI & F2F assessment tools
- ICD-9/ ICD-10 coding schemes in LTCAS & CLTCAS
- Drug lists in LTCAS & CLTCAS
- Assist on ad hoc projects as requested
Requirements
- Knowledge, Skills & Abilities
- Conducts the quality assurance review of individual underwriters within written guidelines
- Has knowledge of all client protocols and processes to evaluate the performance of others
- Prefer a minimum of 24-36 months of Lead Underwriter level experience, or equivalent, based on overall job performance
- Customer focused toward internal and external clients
- Flexible with the ability to work on multiple tasks · Detail oriented with excellent organizational skills
- Good interpersonal skills, with excellent written and verbal communication skills
- Ability to analyze processes and implement innovative ideas to improve efficiencies
- Demonstrated leadership abilities and team player
- Demonstrated problem solving and decision making skills
- Comprehensive knowledge of computer skills including word processing and use of Windows
EDUCATION/EXPERIENCE
- Knowledge of long term care needs of individuals
- Knowledge of life insurance and combo products in underwriting capacity
- 5 years Senior Level underwriting experience
- Five or more years’ recent work experience in a related area that includes long term care, home health care or acute care
Location
REMOTE, MN, USA
5+ years senior-level underwriting experience; 5+ years in long-term care, home health, or acute care; knowledge of life insurance and combo products; strong communication, leadership, and computer skills including Windows.
Key Responsibilities
- conducting quality audits
- providing training
- developing teaching materials
Skills & Tools
Windows, LTCAS, CLTCAS
Job Details
- Category: Human Resources
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — Minnesota, United States
- Languages: English
About illumifin
A company providing underwriting and quality assurance services in the insurance sector. — Industry: Finance