Medical Advisor

Job Description

Are you a person with strong decision-making skills? Are you interested in working in a multilingual, dynamic, and friendly environment that encourages personal and professional development?

Do you want to be part of a talented team that genuinely cares about client and employee well-being? We would love to meet you!

The Case Management department, who is responsible for prompt delivery of high-quality, cost-efficient case management for inpatient and complex outpatient claims, is looking to add a Medical Advisor to the team.

The Medical Advisor works closely with in-house Medical Directorship to assess claim acuity and steer medical decision making in active claims.

The Medical Advisor supports the Case Manager and Medical Review teams with medical decisions in both active claims and post-care reviews.

The Medical Advisor also proposes solutions to enhance service delivery and assists in the overall development and implementation of leading medical cost mitigating strategies that result in the positive impact of our medical claims costs while ensuring adequate patient care.

What does your typical day look like?

• Oversee and consult on cases to promptly identify clinical risk, including inability to access medical care and inappropriate treatment;
• Contact Treating Medical teams to discuss patient care and readiness for travel home.
• Share knowledge, coach, and lead the case managers, case coordinators, & coverage assessment teams to ensure the use of Insurance Medicine;
• Pro-actively assess and provide guidance in medical and case management decisions for in-patient and out-patient cases;
• Prepare medical summaries for active inpatients or complex outpatients and updates to corporate clients. Maintain effective communication between both as well as medical providers;
• Facilitate and lead internal rounds, when required;
• Facilitate and lead active case review meetings with underwriters when required;
• Identify opportunities to strengthen the medical team’s knowledge of case management best practices in the US and contribute to the process of enhancing service delivery of case management services outside the US.

What skills and training do you need?

• Medical degree, (MD or DO) or Nursing degree (BScN or NP), Physician's assistant, or equivalent clinical training / experience;
• Understanding of Milliman Care Guidelines;
• License to practice anywhere in the world is an asset;
• Knowledge of the US health care system and processes;
• Knowledge of best practices in Clinical Medicine with validation using tools such as UpToDate;
• Knowledge and understanding of insurance Medicine and Case Management best practices;
• Underwriter product knowledge and understanding of their culture and expectations;
• Strong communication skills with the ability to present & communicate information in small and large group settings, while being able to deliver business results and deliver customer value.

When you apply :

If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs.

We offer you

• Global Excel offers more than a position;
• We offer a competitive compensation package that includes a base salary, performance bonus and an extensive benefits package;
• A professional future with opportunities for development, growth, and advancement;
• Licensing fee reimbursement and bilingual bonus (when applicable);
• RRSP Match program;
• Financial assistance to employees who wish to continue their education;
• Work / life balance, health and wellness initiatives including an excellent EAP program;
• Employee engagement programs that focus on fitness, food, and fun.

To get a taste of the Global Excel life and for more information on our company, visit our Facebook page and website :

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