Evolve Claim Solutions Jobs (NOW HIRING)

Location Designation: Fully Remote
Role Overview:
The Medical Director - Medical Management Role is a clinical professional who as part of a team of specialty medical directors, provides expert medical analysis of complex disability claim files in oral and written format. The Medical Director will collaborate with a multidisciplinary team of Medical Directors, Nurses, Behavioral Health Specialists, and Vocational Coaches in supporting our Claims Team in better understanding our customers, their clinical conditions, functional limitations, residual capacity, and disability. The successful medical director demonstrates clinical expertise in their specialty, has in depth understanding of functional impairment and activity ability, is able to quickly develop rapport with non-clinical and clinical colleagues including the customer's treating provider, and effectively formulates and communicates a summary analysis of clinical information.
What You'll Do:

• Support Group Benefit Solutions business initiatives with Integrity, Objectivity and Customer focused Urgency
• Consistently and efficiently review disability claims files and provide high quality written analysis of complex disability claim files which are consistent with company and industry standards
• Perform outreach calls and/or written communication with the customer's attending healthcare provider which facilitate development of an understanding of the customer's conditions, function, recovery/ongoing care and which appropriately promotes safe return to activity for the customer
• As a Medical Resource and Leader: Promote, facilitate, and contribute in a meaningful way during collaborative discussions of Disability Claim files with internal business partners
• Regularly participate in multidisciplinary claim directional discussions

• Participate in developing and conducting training curricula for medical directors, nurses and nonclinical team members
• Participate in Special Projects and initiatives

What You'll Bring:

• Current and Active Unrestricted Licensure in a US State required
• Current Board Certification in area of clinical expertise (ABMS/AOA, ABPP, ABSNP)
• A minimum of 5 years clinical experience/direct patient care beyond residency or fellowship with strong clinical background
• Certification and/or Experience in Pain Management or Neuromuscular Medicine is a Plus
• Experience in private/public sector disability programs/insurance or other corporate environment highly preferred - analytic skills appropriate to private insurance environment highly preferred. Service, marketing, sales, and business experience a plus.
• Exhibit ethical and professional behavior
• Excellent oral and written communication skills.
• Demonstrate excellent organizational skills, strong and effective teamwork, negotiation, conflict management, decision making and problem solving skills
• Computer competency: word processing, spreadsheet, email and personal information management programs are used extensively and competency in them must be possessed or rapidly acquired; must be able to perform research on Internet resources.
• Demonstrate a highly developed understanding of the benefits of return to activity and remaining in the workforce
• Successful ability to assess complex issues, to determine and implement their solutions, and to resolve problems.
• Success in carrying out and maintaining cooperative, successful relations with diverse internal and external stakeholders.
• Demonstrate sensitivity to culturally diverse situations, participants and customers.
• Demonstrate the ability to be effective in large, complex, highly matrixed organization with a changing business environment

Training & Development:
The Medical Director will engage in a comprehensive orientation / training program. Coaching, feedback, and team support are provided to promote a successful onboarding experience.
Shift Information:
This is a full-time work from home position Monday through Friday. Candidates must be available to work 8-hour shifts from 8am-5pm or 9am-6pm.
Salary:
Competitive full-time base salary, plus target bonus if eligible based on performance.
Benefits:
Paid Vacation, Health Care, 401K match, Tuition Assistance, Flexible Spending Accounts.
Pay Transparency
Salary Range: $218,000-$294,500
Overtime eligible: Exempt
Discretionary bonus eligible: Yes
Sales bonus eligible: No
Actual base salary will be determined based on several factors but not limited to individual's experience, skills, qualifications, and job location. Additionally, employees are eligible for an annual discretionary bonus. In addition to base salary, employees may also be eligible to participate in an incentive program.
Company Overview
At New York Life, our 180-year legacy of purpose and integrity fuels our future. As we evolve into a more technology-, data-, and AI-enabled organization, we remain grounded in the values that drive lasting impact.
Our diverse business portfolio creates opportunities to make a difference across industries and communities-inviting bold thinking, collaborative problem-solving, and purpose-driven innovation. Here, you'll find the rare balance of long-standing stability and forward momentum, supported by an inclusive team that honors tradition while embracing progress.
As a Fortune 100 mutual company, we offer a place to grow your skills, contribute to meaningful work, and deliver solutions that matter. Your ideas drive what's next, and your growth powers it.
Our Benefits
We provide a full package of benefits for employees - and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work.Click hereto discover more about our comprehensive benefit options or visit our NYL Benefits Site.
Our Commitment to Inclusion
At New York Life, fostering an inclusive workplace is fundamental to who we are and how we serve our communities. We have a longstanding commitment to creating an environment where individuals can contribute their best and succeed together. This foundation is rooted in our core values of humanity and integrity, ensuring that every employee feels valued and supported. By embracing a broad range of perspectives and experiences, we achieve greater success and fulfill our promise of providing financial security and peace of mind to families across all communities. Click here to learn more about New York Life's leadership in this space.
Recognized as one of Fortune's World's Most Admired Companies, New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by the Foundation. We're proud that due to our mutuality, we operate in the best interests of our policy owners. To learn more about career opportunities at New York Life, please visit the Careers page of www.NewYorkLife.com.
Visit our LinkedIn to see how our employees and agents are leading the industry and impacting communities.
Visit our Newsroom to learn more about how our company is constantly evolving to meet our clients' and employees' needs.
Job Requisition ID: 93888
About NY Life Insurance Company
Diversity & Humanity-two values that are deeply rooted in the New York Life culture and have laid the foundation for over 175 years of commitment to our employees, agents, policy owners, and the communities where we live and work. At New York Life you become a valued part of a welcoming, inclusive, and caring culture that has a long-standing legacy in stability and growth. The strength of New York Life revolves around our diversified, multi-dimensional business portfolio that goes beyond life insurance, and we want you to be a part of our legacy.
As a Fortune 100 company and industry leader, we provide an environment where you can explore your career ambitions, offering opportunities to tackle meaningful challenges and stretch your skills while balancing work and life priorities. You will be part of a diverse team guided by our belief to always be there for each other-providing the support and flexibility to grow and reach new heights while making an impact in the lives of others.
You are our future, and we commit to investing in you accordingly.
Visit our Linkedin to see how our employees and agents are leading the industry and impacting communities.
Visit our Newsroom to learn more about how our company is constantly evolving to meet our clients' and employees' needs.
Required Legal Notices - All Candidates Please Click Here