Medical Director, PinnacleCare

Sun Life U.S. is one of the largest providers of employee and government benefits helping approximately 50 million Americans access the care and coverage they need. Through employers industry partners and government programs Sun Life U.S. offers a portfolio of benefits and services including dental vision disability absence management life supplemental health medical stop-loss insurance and healthcare navigation. We have more than 6400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers partners and communities.

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Internal candidates are not required to relocate near an office.

The opportunity: The Medical Director serves as the clinical and strategic leader for the organizations medical advisory operations. This physician ensures the highest standards of medical accuracy clinical insight and operational effectiveness across the companys services to shape medical strategy and ensuring the highest quality guidance for members navigating complex healthcare decisions. The Medical Director does not provide direct patient care but instead provides oversight clinical judgment and expert guidance to support advisors members research teams and clinical relations

How you will contribute:

Strategic Development & Collaboration

• Collaborate with organizational leadership to expand and manage Medical Advisory Board and provider referral network
• Collaborate with the Chief Medical Officer (CMO) on innovative ways to increase member engagement and realized value to drive membership renewal and persistency
• Collaborate with executive leadership to refine the companys medical strategy product development service enhancements content standards and client deliverables
• Stay current with emerging medical trends therapies and technologies relevant to advisory services
• Assist in shaping PinnacleCares value proposition and differentiation in the market place

Clinical Leadership & Advisory

• Provide medical advisory direction and management
• Serve as a senior escalation point for complex high-acuity and sensitive clinical cases
• Recommend appropriate physician specialties and centers of excellence based on individual member medical needs
• Provide phone support for members with complex multi-system medical conditions when necessary
• Supervise the remote second opinion program for members and develop frameworks and criteria to guide when a second opinion or further evaluation is indicated

Team Management & Leadership

• Manage the physician chart review team
• Oversee medical services team and coordinate PinnacleCare physician on-call program
• Mentor coach and support assistant medical directors

Quality Assurance & Standards

• Lead development of medical review processes clinical standards and quality assurance programs
• Partner with director of research on content and accuracy of medical intelligence research reports
• Evaluate and recommend appropriate centers of excellence and subspecialty referrals

Education & Training

• Provide medical education curriculum for advisors and team leaders and when necessary with members for critical new or evolving medical information (ie epidemics breakthroughs)
• Mentor interns assigned to PinnacleCare for clinical content projects

What you will bring with you:

• Ability to work with a diverse range of people
• MD from an accredited medical school with active unrestricted U.S. medical licensure
• Min 5 years of clinical experience
• Certification by an ABMS board
• Active and unrestricted medical license
• Strategic thinker with strong attention to detail
• Empathetic communicator able to bridge clinical and lay perspectives
• Collaborative leader who thrives in a multidisciplinary fast-paced environment
• Committed to medical accuracy ethical standards and continuous improvement
• Proficiency with Microsoft office Suite
• Strong problem-solving organizational and analytical skills

Salary:

$162700-$244100

At our company we are committed to pay transparency and equity. The salary range for this role is competitive nationwide and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills qualifications experience education and geographic addition to your base salary this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong are supported and empowered to thrive. We are dedicated to building teams with varied experiences backgrounds perspectives and ideas that benefit our colleagues clients and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life we prioritize your well-being with comprehensive benefits including generous vacation and sick time market-leading paid family parental and adoption leave medical coverage company paid life and AD&D insurance disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match stock purchase options and an employer-funded retirement account. Enjoy a flexible inclusive and collaborative work environment that supports career growth. Were proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S. weve also been recognized as a Top 10 employer by the Boston Globes Top Places to Work for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans unless the accommodation would impose an undue hardship on the operation of our business. Please email to request an accommodation.

For applicants residing in California please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of applicable state and local laws including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.