Clinical Medical Review - Oncology (Underwriting) (JR192475)

Clinical Medical Review – Oncology (Underwriting) (JR192475) Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Medical Underwriter Sr (Clinical Review) is responsible for determining acceptability of medically underwritten risks for more complex cases. Responsibilities Calculates appropriate group/individual premium rates for new business and renewal in accordance with Corporate Underwriting Guidelines and federal and state statutes. Proposes new business rates for complex cases ensuring rating compliance, utilizing a combination of medical applications, additional medical information, and manual rates. Calculates renewal rates for complex cases utilizing a thorough analysis of medical experience, location, demographic nature, etc. Evaluates medical information in order to assign appropriate underwriting decision. Monitors and reviews rating compliance reporting with actuaries for assigned business. Analyzes and responds to written and verbal underwriting inquiries. Participates in and may lead special underwriting projects. Interacts frequently with brokers and sales, administration and actuarial areas. Minimum Requirements Requires a BA/BS in a related field; Minimum 3 years of related experience; or any combination of education and experience that would provide an equivalent background. Preferred Skills, Capabilities and Experiences RN license strongly preferred. 5 years of clinical experience in Oncology setting strongly preferred. Clinical documentation / medical chart review experience strongly preferred. Utilization Management experience preferred. Salary range: $79,200 to $129,600 (may vary by location, experience, education, and skill level). Locations: Illinois; Minnesota, New York, New Jersey Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration. #J-18808-Ljbffr Elevance Health