Stop Loss Clinical Underwriting Consultant

Together we fight for everyone’s opportunity for a better financial future.

We will do this together — with customers, partners and colleagues. We will fight for others, not against: We will stand up for and champion everyone’s access to opportunities. The status quo is not good enough … we believe every individual and every community deserves access to financial opportunities. We are determined to support both individuals and communities in reaching a better financial future.  We know that reaching this future depends on our actions today.

Like our Purpose Statement, Voya believes in being bold and committed to action.  We are committed to a work environment where the differences that we are born with — and those we acquire throughout our lives — are understood, valued and intentionally pursued. We believe that our employees own our culture and have a responsibility to foster an environment where we all feel comfortable bringing our whole selves to work. Purposefully bringing our differences together to positively influence our culture, serve our clients and enrich our communities is essential to our vision.

Are you ready to join a company with a strong purpose and a winning culture? Start your Voyage – Apply Now

Get to Know the Opportunity:

Favorably impact Stop Loss risk profile through early identification of potential high cost patients.

The Contributions You'll Make:

• Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the severity of medical conditions, and estimate the duration of treatment and expected future costs.

• Researches clinical conditions and provides analytical review of the medical and/or pharmacy data to formulate the history of events. Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data.

• Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision

• Works collaboratively with the cost containment team ensure a proper hand off of potential high cost patients. Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate Cost Containment specialty teams to address these identified risks.

Minimum Knowledge & Experience:

• Bachelor’s degree - current unrestricted RN license, or equivalent clinical degree

• Minimum 5 years of clinical experience

• Minimum 2 years insurance experience

• Analytical and problem solving skills

• Excellent interpersonal and negotiation skills to act as a company representative

• Experience in Microsoft Office products

#LI-KD1

#LI-Remote

Compensation Pay Disclosure:

Voya is committed to pay that’s fair and equitable, which means comparable pay for comparable roles and responsibilities.

The below annual base salary range reflects the expected hiring range(s) for this position in the location(s) listed. In addition to base salary, Voya offers incentive opportunities (i.e., annual cash incentives, sales incentives, and/or long-term incentives) based on the role to reward the achievement of annual performance objectives. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Voya Financial is willing to pay at the time of this posting.

Actual compensation offered may vary from the posted salary range based upon the candidate’s geographic location, work experience, education, licensure requirements and/or skill level and will be finalized at the time of offer. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.

Be Well. Stay Well.

Voya provides the resources that can make a difference in your lives. To us, this means thriving physically, financially, socially and emotionally. Voya benefits are designed to help you do just that. That’s why we offer an array of plans, programs, tools and resources with one goal in mind: To help you and your family be well and stay well.

What We Offer

• Health, dental, vision and life insurance plans
• 401(k) Savings plan – with generous company matching contributions (up to 6%)
• Voya Retirement Plan – employer paid cash balance retirement plan (4%)
• Tuition reimbursement up to $5,250/year
• Paid time off – including 20 days paid time off, nine paid company holidays and a flexible Diversity Celebration Day.
• Paid volunteer time — 40 hours per calendar year

Learn more about Voya benefits (download PDF)

Critical Skills

At Voya, we have identified the following critical skills which are key to success in our culture:

• Customer Focused: Passionate drive to delight our customers and offer unique solutions that deliver on their expectations.
• Critical Thinking: Thoughtful process of analyzing data and problem solving data to reach a well-reasoned solution.
• Team Mentality: Partnering effectively to drive our culture and execute on our common goals.
• Business Acumen:Appreciation and understanding of the financial services industry in order to make sound business decisions.
• Learning Agility: Openness to new ways of thinking and acquiring new skills to retain a competitive advantage.

Learn more aboutCritical Skills

Equal Employment Opportunity

Voya Financial is an equal-opportunity employer. Voya Financial provides equal opportunity to qualified individuals regardless of race, color, sex, national origin, citizenship status, religion, age, disability, veteran status, creed, marital status, sexual orientation, gender identity, genetic information, or any other status protected by state or local law.