Departments

Actuarial
Customer Experience
Finance
Health Informatics
Information Technology
Pharmacy and Care Management
Sales and Marketing
Students and Recent Grads

Actuarial

The Actuarial department analyzes historical data to determine rates and provides guidance based on their findings.  Actuaries also evaluate the financial impact of company decisions and give input on future actions. Examples include:

• Working with the Sales department to price products
• Establishing reserve
• Reviewing the Affordable Care Act and other regulations  and estimating their impact on premiums
• Analyzing data and forecasting future premiums and claims
• Reviewing claims utilization and evaluating provider contracting trends

Customer Experience

The Customer Experience area is made up of many different departments throughout the company that deal directly with our customers and how they interact with Medical Mutual including:

Customer Care

Our Customer Care specialists use phone, email, online chat and written correspondence resources to serve our members, healthcare providers, employer group officials and brokers.

Membership and Billing

This department maintains customer records and communication preferences and is responsible for generating monthly premium bills.

Member Engagement

The Member Engagement department oversees our digital properties for members, including My Health Plan (our members-only website), our mobile application and other online tools. This department also provides analytics and insights to measure and improve the overall experience of our members.

Claims Operations

This area is responsible for end-to-end claims processing, which involves claims intake, processing and payment. Claims Operations also provides benefit coding, recoveries and avoidance, corporate performance, appeals and project administration.

Cash Control

The Cash Control department provides cashier, credit and collection services for our customers. 

Finance

Medical Mutual’s Finance department works to ensure a strong future for the company by assisting with various financial decisions. Examples of the Finance department’s work include:

• Understanding budgets
• Preparing financial statements
• Forecasting
• Payroll and tax compliance
• Passing cost-savings on to our members

Several key areas make up the Finance department, including Financial Reporting, Financial Analysis, Corporate Tax,  Broker Administration and ASO Billing. The department is fast-paced to make sure financial transactions are properly analyzed and accounted for. 

Health Informatics

The Health Informatics department investigates and analyzes data to help our members and customers:

• Improve their overall health
• Slow diseases that can progress, like diabetes and high cholesterol
• Control increasing healthcare costs

Health Informatics gathers this data directly from our own automated systems and from external sources. We evaluate this data using automated tools, including SAS, Optum’s Impact Intelligence, Optum’s Impact Pro and many other business-specific tools.

In addition, Health Informatics leads corporate initiatives related to enterprise data architecture, data interface homogenization and analytical tool research and selection. 

Information Technology

Information Technology is at the heart of everything we do at Medical Mutual. We have state-of-the-art infrastructure and data centers, as well as large web and mobile development initiatives that help our customers. Our Information Technology department employs developers, designers, analysts and project managers. Many of our teams use Agile software development practices, while other teams use a hybrid approach. All of our IT teams form strong partnerships with other departments throughout the company to deliver quality products for our users.

We support a variety of websites and applications, including:

• Corporate websites
• My Health Plan, our online member portal
• Mobile applications
• Customer Service systems
• Healthcare informatics and reporting
• Core claims and customer data management systems

Pharmacy and Care Management

Medical Mutual’s Pharmacy and Care Management area focuses on improving the health and well-being of our members. To do so, we:

• Give our members the tools they need to navigate the healthcare system, improve or maintain their health and be better healthcare consumers.
• Promote evidence-based medicine and quality metrics to our providers, with the goal of improving our members’ health.
• Ensure our services are clinically correct, support best practices, are measureable and used by our members.

Medical Mutual’s Pharmacy and Care Management department employs a variety of healthcare professionals like physicians, nurses, pharmacists, social workers and more.

Sales and Marketing

Sales and marketing play a key role in recruiting and maintaining membership in Medical Mutual plans. Our teams collaborate to keep Medical Mutual and the products we sell top of mind with a variety of segments.

Group Sales

Our experienced and knowledgeable Group Sales and Account teams work directly with insurance brokers, consultants and corporate Human Resources leadership to offer solutions that meet employers’ health plan needs. Our staff is trained to consult on a variety of trends and solutions, including:

• Plan design consultation
• Delivery and analysis of actionable reporting 
• Member communication and interaction
• Promotion of wellness programs and initiatives
• Underwriting and risk calculation
• Healthcare reform

Individual Sales

Our Individual Sales team manages our Medicare Advantage and Medicare Supplement insurance plans and plans available for individuals and families under age 65. The Individual Sales department employs analysts, licensed insurance agents and more. Our agents work directly with individuals shopping for insurance, helping them understand their best options through direct consultation and events in the community.

Multi-Channel Marketing and Advertising

The Multi-Channel Marketing and Advertising area helps to increase Medical Mutual’s profitability and market share by using a variety of marketing tactics. From developing marketing strategies to tracking results, the department manages many interesting projects. Examples of the department’s work include:

• Campaign strategy, planning and creation
• Brand management
• Market research, including surveys and focus groups
• Direct marketing
• Digital marketing
• Search engine optimization and search engine marketing
• Print, online, display and television advertising
• Website development
• Content development and copywriting
• Campaign tracking and ROI analysis

The Multi-Channel Marketing and Advertising department also includes the Marketing Communications department and the Advertising & Design department. These departments create resources to help sell our products, including brochures, fliers, letters, newsletters and product updates. Marketing Communications also creates internal and external pieces to communicate with our Sales department, employer groups, brokers and providers.

Underwriting

The Underwriting department plays a key role in the company’s continued growth and profitability. The department’s main functions include evaluating risk, providing cost projections and establishing premium rates for our customers. Underwriting also collaborates with the our Sales department to develop strategies that win new members and retain existing ones. In addition, the department puts adequate controls in place to protect financial integrity, profitability and compliance. Bottom line: the department combines math and judgment to provide the best solution for our members.

Students and Recent Grads

Medical Mutual offers two programs to help you transition from college to professional life. Our College Internship Program and our Career Development Program will help you grow personally and professionally. We accept applications for both programs during September and October every year.

Learn more about our programs for students and recent grads.