Medical Review Specialist

Prudential Financial companies serve individual and institutional customers worldwide and include The Prudential Insurance Company of America, one of the largest life insurance companies in the United States. These companies offer a variety of products and services, including life insurance, mutual funds, annuities, pension and retirement-related services and administration, asset management, banking and trust services, real estate brokerage franchises, relocation services and, through a joint venture, retail securities brokerage services. For more information, visit www.prudential.com The incumbent provides centralized oversight of the process for conducting external medical reviews/assessments such as Independent Medical Examinations, Functional Assessments and/or File Reviews, to achieve an efficient and effective use of this clinical tool in conjunction with other claim and risk management tools. The incumbent identifies claims that are appropriate for external review, identifies the appropriate medical specialty, and provides focused questions to be addressed by external reviewers. Identifies cost saving alternatives to external medical review (e.g. claimant visit, surveillance, etc.). Ensures appropriate internal clinical resources are utilized/maximized prior to initiating an external review process. The incumbent maintains a data base of appropriate external review providers and manages vendors and vendor relationships to ensure high quality, cost effective service..  Position will be working out of the Roseland, NJ location.   ** Bachelor's Degree required. ** Ability to work effectively with minimal supervision ** Creative thinking skills ** Excellent organizational skills/ability to effectively multitask ** Excellent Written and Verbal Communication Skills ** Excellent partnering skills ** Process management skills ** Proficiency with Microsoft Office 2000 (Word, Excel)  Prudential is an Equal Opportunity/Affirmative Action Employer and is committed to diversity in its workforce.