Medical Consultant
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Medical Consultant guiding MassMutual’s life insurance underwriting and disability claims risk assessments. Reviewing clinical evidence and shaping medical underwriting guidelines.
Responsibilities:
- Evaluate complex and medically challenging individual life insurance underwriting and disability claims referrals
- Review, interpret, and evaluate attending physician statements, medical records, laboratory results, diagnostic studies, and specialist reports
- Identify relevant mortality and morbidity risks
- Read and interpret EKG/ECG results and other diagnostic testing
- Provide education and medical consultation to underwriters, claims examiners, and business partners
- Lead and contribute to the development, review, maintenance, and enhancement of underwriting medical manuals, guidelines, and reference materials
- Maintain expert-level knowledge of medical literature, clinical developments, treatment advances, and emerging trends relevant to insurance medicine and risk assessment
Requirements:
- Bachelor of Science in Nursing
- Active license as one of: RN, NP, APRN, or 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 of experience interpreting EKG/ECG findings within a clinical or insurance medical setting
- Advanced clinical credential such as APRN, NP, CNS, PA-C, MD, or DO (ideal)
- Certification in Insurance Medicine, such as ALU, FALU, FLMI, CLU, or equivalent insurance-related designation (ideal)
- Experience developing underwriting guidelines, medical manuals, or clinical decision-support tools (ideal)
- Experience designing and delivering training programs for underwriting, claims, or medical professionals (ideal)
- Bilingual proficiency in Spanish and/or Mandarin (ideal)
- Expertise in mortality and morbidity risk assessment within life insurance, disability insurance, or related financial services environments (ideal)
- Experience leading cross-functional initiatives and influencing business partners on medical risk strategy (ideal)
- Strong written and verbal communication skills (ideal)
Benefits:
- Competitive salaries
- Incentive and bonus opportunities
- Clear areas of ownership and accountability
- Collaborative environment where perspectives are welcomed
- Access to learning, development, and internal networks
- Employee-led communities and forums supporting connection, learning, and inclusion
- Inclusive, vibrant, and diverse culture
- Industry leading pay and benefits
- Accommodation support during the application process
Similar Jobs
Technical Consultant – North Rhine-Westphalia, Remote
Technical Consultant für ASTRUM ITs Besuchermanagementsoftware VISIT. Verantwortlich für Implementierung, Customizing, Schulung und strategische Kundenbetreuung in Nordrhein-Westfalen.
Capital/Fixed Asset Consultant
Capital/Fixed Asset Consultant conducting GASB compliance, equipment inventories, cost segregation, and space utilization studies. Supporting HCA’s corporate, university, and government clients across the United States.
Clinical Consultant
Remote Clinical Consultant conducting hospice chart audits, compliance reviews, and mock surveys. Supporting home care and hospice clients through clinical consulting and Medicare expertise.
Professional Services Consultant – Self Service
Professional Services Consultant deploying Abnormal AI’s cybersecurity SaaS across Microsoft 365 and Google Workspace. Managing high-volume self-serve implementations to rapid customer value.
Senior Network Management Consultant – Behavioral Health
Remote behavioral health network consultant recruiting and negotiating provider contracts for HCSC health plans. Managing provider relationships, coverage, and contract changes across assigned markets.
Utilization Management Nurse Consultant
CVS Health Utilization Management Nurse Consultant reviewing clinical information and recommending coverage. Coordinating care and referrals to improve member healthcare outcomes remotely.
Technical Customer Advisor – Technical Consultant, Profit Center Machines
Technischer Kundenberater für klarx, einen digitalen Baulogistiker und Baumaschinenvermieter. Betreuung italienischer Mietprojekte, Vermietpartner und Kunden remote aus Italien oder Deutschland.
ERISA Consultant
ERISA Consultant delivering IRS and DOL correction consulting for FuturePlan, a national retirement-plan administrator. Performing Excel calculations, technical research, training, and regulatory analysis.
Application Integration Consultant – V
Application Integration Consultant V advising customers and designing scalable application, data, and security solutions. Building and optimizing end-to-end multicloud services at Rackspace Technology.
Senior Data Consultant
Senior Data Consultant delivering ERP data migration projects for global enterprises at Syniti, part of Capgemini. Building migration rules, load programs, reports, and reconciliations.
Lead Travel Consultant, French Speaking
Lead Travel Consultant arranging complex corporate air, road, rail, and hotel travel for Amex GBT clients. Delivering French-language, high-touch service through GDS platforms.
Senior Solution Consultant – Sustainability
Senior Solution Consultant guiding Workiva customers on sustainability, data integration, and AI solutions. Leading enterprise presales, technical discovery, demos, proposals, and transformation initiatives.
Solution Consultant – Nordics
Solution Consultant driving technical wins for Workiva’s financial reporting, GRC, and sustainability platform. Building demos, prototypes, and proofs of concept for Nordic customers.
Appeals Nurse Consultant
Appeals Nurse Consultant reviewing and resolving clinical appeals for CVS Health and Aetna. Applying clinical criteria, policies, and regulatory knowledge in a 100% remote role.
Senior Consultant de Gobierno de Identidades, IAM
Consultor/a Senior de Gobierno de Identidades para knowmad mood, compañía de transformación digital. Definición de controles, KPIs y procesos IAM en proyectos corporativos de ciberseguridad.
Nurse Consultant, Medical Office
Nurse Consultant advising on life and health insurance claims and disability management at Desjardins. Reviewing medical plans, coordinating diagnoses, and negotiating return-to-work terms.
Nurse Consultant, Medical Office
Nurse Consultant advising Desjardins on life and health insurance claims and disability management. Reviewing medical plans, coordinating diagnoses, and negotiating return-to-work terms.
Senior Consultant – Clinical Trials Focus
Senior Consultant leading clinical-trial and regulatory consulting engagements for Lumanity, a global healthcare strategy partner. Delivering client recommendations, proposals, and complex life-sciences analyses.
SuccessFactors Employee Central Consultant
SAP SuccessFactors Employee Central Consultant configuring and supporting HR and payroll solutions at Zalaris. Resolving incidents, delivering enhancements, testing changes, and training customers.
Senior OIC Consultant
Senior OIC Developer building Oracle ERP Cloud integrations for bTranz Software Solutions. Supporting GCC/Saudi compliance, testing, reporting, and enterprise integration delivery.