Medical Director - Assistant Vice President, Group Insurance
Lead Sun Life's U.S. Group and Voluntary Claims Medical Strategy, providing leadership and medical expertise to develop and execute on industry leading capabilities and practices in the Disability, Absence, Life and Worksite claims arena.
RESPONSIBILITIES • Develop Sun Life’s Claims Medical Strategy, working closely with the AVP of Clinical Services, to enhance return to work outcomes, claims management effectiveness, and service excellence objectives.• Oversee vendor and internal/contracted physician practices and quality• Review clinical records on complex group disability and Life claims and communicate with providers and other parties to facilitate the clinical aspects of the benefits determination process• Advance Sun Life's "WisH" ("Work Is Healthy") philosophy through accurate assessment of functionality, work capacity, and application of innovative return to workstrategies.• Develop impairment based protocols and STD duration management guidelines and tools.
*ML-1 QUALIFICATIONS • MD or DO plus Board certification in related specialty field (PM&R, Occ Med, Internal Medicine) and appropriate current medical licensures• Understanding of corporate health and productivity and employee wellness principles and practices• 5+ years of direct patient care plus experience in a business setting• Collaborative and comfortable navigating in cross functional organizations with matrixed accountabilities.• Excellent communication (oral and written) and public speaking skills, especially in client meetings and industry conferences. Ability to convey complex medical concepts toclaims analysts.• Ability to travel moderately (<25%) to support client and business meetings.