VP-Medical Claims

Company Overview

Northwestern Mutual is a FORTUNE 109 company with $41B in revenue that provides a wide range of financial services to free Americans from financial anxiety. As the leading provider of life insurance, we generate an impressive revenue of $40 billion and serve over 5 million customers.

Role Summary

We are seeking a Vice President of Claims for our medical organization, to serve as a senior medical authority who will bridge clinical medicine with risk management. They will translate medical science into underwriting guidelines, assess mortality/morbidity risks for high-value policies, guide claims assessment, and ensure regulatory compliance.

Our medical team currently consists of approximately 30 industry professionals including RNs, MDs and Dos. This specialized team has recreated the collegial environment from days in clinical practice. The focus is to find innovative ways to promote health, predict risk and prevent mortality and morbidity experience, while setting the tone for the entire enterprise.

Job Responsibilities

• Support company goals for mortality and morbidity by setting medical standards for Life, Disability, and Long-Term Care products.
• Facilitate expertise to utilize the standards by supporting the education of the underwriters.
• Bring medical consultations and leadership to a broad spectrum of Company departments (Actuarial, Law, Government Relations, Compliance, Communications, Philanthropy, Innovation, NM Venture Funds).
• Provide medical case consultations/referrals with underwriting and benefits areas (Life, Disability, and Long-Term Care).Direct or participate in special projects and committees as designated by the Vice President and Chief Medical Director.
• Train and onboard Associate Medical Directors new to insurance medicine.
• Perform 2nd sign reviews on Jumbo Life cases.
• Collaborate with the CV Medical Consultants (RNs) for Cardiovascular Risk Assessment.
• Contribute to insurance medicine associations which include planning meetings, speaking at industry events and conferences, holding office, and setting professional standards.
• Partner and support internal stakeholders from underwriting, claims, field and policyowners and offer guidance complex medical claims issues including contestable death claims.

Qualifications:Complete a MD or DO degree, primary care residency training, and at least 3 years of clinical experience.Achieve and maintain Board certification in Internal Medicine, Med/Peds, or Family Medicine.Achieve and maintain medical licensing in the state of WisconsinDemonstrate excellent communication skillsAbility to write medical standardsAbility to present at industry meetingsAbility to perform training sessionsAbility to interact professionally with the underwriters, claims analysts, field and policyownersAttainment of Board Certification in Insurance Medicine.Demonstrate digital proficiency with case management and medical record platforms.Exhibit ethical behavior and demonstrate excellent judgment.Be comfortable with change and have flexibility to be a change agent

Compensation Range:

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This role is eligible for additional short-term and long-term incentive compensation.

We believe in fairness and transparency. It's why we share the salary range for most of our roles. However, final salaries are based on a number of factors, including the skills and experience of the candidate; the current market; location of the candidate; and other factors uncovered in the hiring process. The standard pay structure is listed but if you're living in California, New York City or other eligible location, geographic specific pay structures, compensation and benefits could be applicable, click here to learn more.

Grow your career with a best-in-class company that puts our clients' interests at the center of all we do. Get started now!

Northwestern Mutual is an equal opportunity employer who welcomes and encourages diversity in the workforce. We are committed to creating and maintaining an environment in which each employee can contribute creative ideas, seek challenges, assume leadership and continue to focus on meeting and exceeding business and personal objectives.

Medical Case Consultation (NM) - Expert, Customer Centricity (NM) - Expert, Risk Assessment & Identification (NM) - Expert, Strategic Vision & Planning (NM) - Advanced, Insurance Acumen (NM) - Expert, Digital Health Data (NM) - Expert, Coaching & Mentoring (NM) - Expert, Learning Agility (NM) - Expert (Inactive), Statutes & Regulation (NM) - Expert, Medical Acumen (NM) - Expert, Information Gathering (NM) - Advanced, Underwriting Practices (NM) - Expert, Decision Making (NM) - Expert, Medical Standards (NM) - Expert, Technical Problem Solving (NM) - Expert, Medical Risk Assessment (NM) - Expert, Data Application (NM) - Advanced, Underwriting Research (NM) - Expert, Business Influence (NM) - Advanced, Accountability (NM) - Expert, Attention to Detail (NM) - Expert, Medical Trends & Directions (NM) - Expert, Adaptive Communication (NM) - Expert, Mortality, Morbidity, & Risk Analysis (NM) - Expert

We're excited about the potential people bring to Northwestern Mutual. You can grow your career here while enjoying first-class perks, benefits, and our commitment to a culture of belonging.

• Flexible work schedules
• Concierge service
• Comprehensive benefits
• Employee resource groups