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| Company Overview | About Voya India: Voya India (earlier VFISLK) started out as a joint venture between U.S. financial services company Voya Financial and SLK, a software services company and is head quartered at Bangalore. As of Aug 2023, we are a wholly owned subsidiary of Voya Financial. We are a dynamic technology & business process transformation company that provides world-class technology & business process management services, with an emphasis on quality, speed & optimization driven through automation. We support and deliver innovative solutions to Voya’s Retirement, Employee Benefits, and Investment Management businesses. More information about us is available at: https://www.voyaindia.com |
| Role Summary | Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the severity of medical conditions, and estimate the duration of treatment and expected future costs. Researches clinical conditions and provides analytical review of the medical and/or pharmacy data to formulate the history of events. Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data. Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision Works collaboratively with the cost containment team ensure a proper hand off of potential high cost patients. Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate Cost Containment specialty teams to address these identified risks |
| Key Roles & Responsibilities | Bachelor’s degree - current unrestricted RN license, or equivalent clinical degree • Minimum 5 years of clinical experience • Minimum 2 years insurance experience • Analytical and problem solving skills • Excellent interpersonal and negotiation skills to act as a company representative • Experience in Microsoft Office product |
| 6. EDUCATION & CERTIFICATIONS | |
| Education | Graduate |
| Certifications (if any) | |
| 7. LOCATION & WORK ARRANGEMENT | |
| Work Location | Bangalore/Pune/Delhi |
| If Other, specify city/location | |
| Work Model | Hybrid |
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