Lead Medical Risk Consultant

QBE Americas, Inc.; Markham; Hybrid; USD 94,000 - 142,000; Full time

Job summary

An established industry player is seeking a dedicated professional to enhance knowledge in the valuation industry and property market trends. This role involves providing consultancy advice, leading risk assessments, and driving continuous improvement in Accident and Health risk management. The ideal candidate will perform data analysis, produce detailed reports, and engage with clients on high-cost claims. Join a forward-thinking company that values diversity and offers a hybrid working environment, comprehensive benefits, and opportunities for professional growth.

Benefits

Hybrid Working

22 weeks paid leave for family growth

401(k) plan with up to 8% employer match

Well-being programs

Tuition Reimbursement

Employee Networks and Community Engagement

Qualifications

• Bachelor's Degree or equivalent education and work experience required.
• Registered Nurse (RN) certification is a must.

Responsibilities

• Conduct reviews of large claims and perform risk assessments.
• Provide detailed reports on data analysis findings and recommendations.
• Consult with clients on complex claims and risk management strategies.

Skills

Administration Management

Analytical Thinking

Communication

Risk Management

Stakeholder Management

Education

Bachelor's Degree

Registered Nurse (RN) certification

Tools

Excel

Job description

Primary Details

Time Type: Full time

Worker Type: Employee

The Opportunity:

The purpose of this role is to provide consultancy advice and training to enhance knowledge of the valuation industry and property market trends across Service Delivery and Risk business units. Additionally, to lead risk assessments for Accident and Health (A&H) by evaluating risks, monitoring regulatory changes, and driving continuous improvement to achieve A&H risk management objectives.

• Location: Marblehead, MA, Edina, MN, and Plano, TX
• Work Arrangement: Hybrid, with expected in-office presence 2-3 days per week
• Starting Salary: Between $94,500 and $141,500

Your New Role

• Perform reviews of new business and renewal large claims, and conduct disclosure assessments through clinical and claims data evaluation to identify and quantify risks.
• Provide concise, detailed, and accurate reports of data analysis findings, observations, and recommendations.
• Serve as a subject matter expert for claims and underwriting related to risk management.
• Provide clinical assessments and recommendations for setting reserves on large dollar claims.
• Present in-house clinical education to enhance understanding of high-cost diagnoses and treatment trends.
• Participate in clinical thought leadership, product development, and educational presentations.
• Consult with internal and external clients on high-cost, complex claims and engage in effective clinical risk management strategies.
• Review transplant contracts and vendor selections for quality control to ensure optimal options.
• Build relationships with key stakeholders to communicate risk factors and develop recommendations for continuous improvement.

Required Qualifications

• Bachelor's Degree or equivalent education and work experience
• Registered Nurse (RN) certification

Preferred Experience

• Strong communication skills to explain and justify work products
• High attention to detail
• Strong analytical skills for pattern recognition and report analysis
• Proficiency in Excel for data sorting and review
• Understanding of the healthcare continuum and operations
• Experience in case management
• Ability to work with limited information, especially when comprehensive data is unavailable

Compensation Package

The salary range is as specified above. The offer will depend on role complexity, location, and candidate background. Employees are also eligible for an annual discretionary bonus based on performance. We encourage all candidates to apply, even if salary expectations are outside the stated range.

QBE Benefits

Our benefits include:

• Hybrid Working - mix of remote and in-office work
• 22 weeks paid leave for family growth, with 12 weeks for all parents
• 401(k) plan with up to 8% employer match
• Well-being programs including coaching, gym memberships, counseling, and financial/legal advice
• Tuition Reimbursement for certifications and education
• Employee Networks and Community Engagement

Learn more at Benefits | QBE US.

Why QBE?

Join us to make a positive impact at work and in the world. We support a resilient future for our customers, communities, environment, and employees. Our global presence offers diverse career opportunities where you can help protect what matters most.

Be part of our success story and help us achieve our goals!

More about us: QBE North America on LinkedIn

Commitment to Diversity

QBE is committed to providing reasonable accommodations for individuals with disabilities and disabled veterans. Please contact our Talent Acquisition team to request accommodations.

Equal Employment Opportunity: We provide equal employment opportunities regardless of race, color, gender, gender identity, sexual orientation, religion, national origin, pregnancy, veteran status, disability, or other protected status.

Additional Information

Skills: Administration Management, Analytical Thinking, Business Process Improvements, Communication, Critical Thinking, Customer Service, Decision Making, Entrepreneurship, Financial Products, Collaboration, Performance Management, Process Refinement, Risk Management, Stakeholder Management

How to Apply

Click "Apply" and follow the instructions to submit your application.