[Hiring] Medical Risk Process Improvement & Training Consultant @Symetra

Role Description

Responsible for developing and delivering training, supporting team member development, and improving processes to promote quality, consistency, and efficiency within the Medical Risk Consultant (MRC) team. This role combines clinical nursing expertise with process ownership and quality oversight to strengthen medical risk assessment practices. The position also performs medical risk reviews to support Underwriting in evaluating potential risks associated with Stop Loss coverage.

What you will do

• Medical Risk Assessment Training and Education:
  • Develop, maintain, and oversee a structured MRC training framework.
  • Design, facilitate, and continually improve training through various methods.
  • Create a supportive and engaging remote learning environment.
  • Establish clear expectations for professionalism and engagement.
  • Promote effective virtual learning practices.
  • Apply clinical expertise and adult learning principles.
  • Identify learning needs through assessments and operational trends.
  • Provide training support to various business partners.
  • Translate complex information into clear learning materials.
  • Maintain organized training resources and documentation.
  • Pilot new training content and evaluate effectiveness.
  • Review the training framework annually.
• Process Ownership and Continuous Improvement:
  • Serve as the primary resource for assigned MRC processes.
  • Evaluate existing workflows for improvement opportunities.
  • Develop and implement routine process improvements.
  • Share proposed changes through the leadership review process.
  • Guide approved improvements from identification to implementation.
  • Investigate operational challenges and identify solutions.
  • Maintain documentation of significant decisions and monitor outcomes.
• Clinical Risk Review and Production Support:
  • Apply clinical nursing knowledge to medical risk assessment.
  • Partner with Underwriting to evaluate claims reports.
  • Use clinical knowledge to evaluate diagnoses and treatment patterns.
  • Prepare accurate and timely written medical risk assessments.
  • Serve as a clinical resource for internal and external partners.
• Trainee Development and Readiness Assessment:
  • Evaluate trainee progress through various assessment methods.
  • Provide timely feedback to reinforce strengths and identify areas for development.
  • Create individualized coaching plans when needed.
  • Maintain documentation of completed training and assessment results.
  • Communicate trainee progress to management.
• Quality Review and Continuous Learning:
  • Develop and carry out a structured quality audit process.
  • Conduct scheduled reviews of medical risk assessments.
  • Evaluate audit findings to identify patterns and opportunities for improvement.
  • Share quality findings with leadership at established intervals.
• Technology Proficiency and Adoption:
  • Maintain proficiency with Microsoft Office Suite and other required platforms.
  • Develop training materials and resources using Microsoft Office applications.
  • Identify opportunities for technology to improve efficiency.
• Quality Collaboration, System Support, and Projects:
  • Partner with management to understand quality trends and process risks.
  • Represent the MRC team in system development and testing activities.
  • Maintain current system procedures and training plans.
• Professional Development and Collaboration:
  • Maintain an active Registered Nurse license and continuing education.
  • Participate in relevant clinical seminars and industry learning opportunities.
  • Foster collaborative working relationships across various departments.

Qualifications

• College degree or certification required.
• RN licensed nurse.
• 5-8 years of cumulative, relevant experience.
• Project Management or Process Improvement certification is a plus.

Benefits

• Flexible full-time or hybrid telecommuting arrangements.
• 401(k) plan with immediate vesting and company matching up to 6%.
• Paid time away including vacation, sick time, flex days, and ten paid holidays.
• Company matching for community contributions.

Compensation

Salary Range: $96,700 - $161,200 plus eligibility for annual bonus program.

Company Description

Symetra is a national financial services company dedicated to helping people achieve their financial goals and feel confident about the future. We are committed to showing up for our communities, lifting up our employees, and standing up for diversity, equity, and inclusion (DEI).