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Medical Operations Associate - Senior

PTZ Insurance Services Ltd.
Full-time
Remote friendly (Ontario EST Canada)
Worldwide

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.

We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.

Established in 2021, Independence Pet Holdings (IPH) is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.

We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach includes our own insurance carrier, insurance brands and partner brands

Independence Pet Group (IPG), a subsidiary of IPH, is one of North America’s largest pet insurance and services organizations. Our impressive family of brands (Figo, Felix, ASPCA Pet Health Insurance, Pets Plus Us, and AKC Pet Insurance) supports insurance for more than 1,000,000 pets in the U.S. and Canada and provides well-being, safety, resources, and business solutions to the pet industry, including microchip identification and an online pet registry.

Job location: Remote

Job Summary: The Medical Operations Associate is a licensed veterinarian who supports and expands the medical governance, clinical adjudication capacity, and cross-departmental veterinary expertise of the Medical Director. This role applies independent clinical judgement, regulatory-aware medical decision- making, and advanced interpretive skills to insurance operations, product strategy, policy interpretation, legal defensibility, and enterprise-wide medical initiatives.

The position functions as the junior analogue to the Medical Director, with responsibilities that require a licensed professional capable of clinical reasoning, risk identification, and contribution to organizational medical standards.

Key Responsibilities:

Clinical Evaluation & Independent Medical Judgment

  • Interpret veterinary medical records, diagnostics, and treatment plans to form clinically sound assessments used in complex claim adjudication and appeals.
  • Determine causation, chronicity, recurrence, and medical necessity using established veterinary standards.
  • Identify medical risk factors, confounding conditions, and inconsistencies that may materially affect claim outcomes.
  • Recommend final coverage outcomes when those outcomes depend on medical interpretation or professional veterinary judgment.
  • Produce clinically defensible analyses that support claims decisions, appeals strategy, and legal positioning
  • Medical Governance, Standards, and Risk Management
  • Apply and help refine internal medical standards, adjudication guidelines, and clinical logic frameworks.
  • Evaluate existing policy wording from a medical standpoint to identify gaps, ambiguities, and operational risk; provide recommendations for future improvements.
  • Assess new diagnostics, treatments, and emerging therapies to ensure operational readiness and alignment with evolving veterinary practice.
  • Support the medical components of fraud investigations, high-risk case reviews, and regulatory or legal inquiries requiring licensed expertise.

Cross-Functional Veterinary Consultation

  • Provide clinically grounded advice to Claims, Appeals, Legal, Compliance, Marketing, Product, and other internal teams.
  • Translate medical concepts into clear, accurate, and operationally appropriate language for non-clinical stakeholders.
  • Participate in cross-departmental decision-making where medical insight influences operational, legal, or strategic outcomes.

Strategic & Enterprise Medical Support

  • Support enterprise initiatives requiring veterinary insight across insurance and non-insurance business units (including microchip and registry operations).
  • Serve as a licensed extension of the Medical Director, assuming delegated responsibilities during absences, high-volume periods, or concurrent organizational priorities.
  • Contribute to long-term medical governance planning, including horizon scanning, literature review, and evaluation of industry trends with business impact.

Communication, Documentation & Internal Knowledge Stewardship

  • Develop high-quality written analyses, medical summaries, and interpretive documents that meet clinical, legal, and regulatory standards.
  • Review internal and external materials for medical accuracy and alignment with current standards of care.
  • Enhance, organize, and expand internal repositories of medical knowledge, case examples, and clinical reference tools for adjuster use.
  • Design and deliver internal medical presentations, including lunch-and-learns, case reviews, or training modules to build organizational clinical literacy.
  • Maintain accurate, accessible internal medical documentation to support adjudication consistency and enterprise medical governance.

Professional Duties

  • Uphold licensed professional standards, ensuring clinical integrity and risk-appropriate interpretation in all work performed.
  • Performs other professional responsibilities requiring veterinary expertise as assigned.

Experience

  • 5+ years of clinical veterinary experience in small animal medicine, including independent case management, diagnostic interpretation, and client-facing medical decision-making.
  • French language proficiency an asset.

Education

  • Doctor of Veterinary Medicine (DVM/VMD/DMV or equivalent), licensed and in good standing in at least one jurisdiction (US or Canada).

Considered Only If No Suitable DVM Applicants Apply:

  • A highly experienced, licensed Veterinary Technician (RVT/LVT/CVT) may be considered only in cases where DVM recruitment is unsuccessful, recognizing that scope of work would be limited and not reflective of the full preferred role.

Accountability/Complexity

  • Exercises independent medical judgment affecting claims outcomes, legal risk, customer impact, and policy interpretation.
  • Routinely evaluates complex medical scenarios involving ambiguous presentations, non-standardized documentation, comorbidities, differential diagnoses, and emerging therapies.
  • Supports the Medical Director in establishing and enforcing medical governance, including coverage standards, medical quality, and operational risk mitigation.
  • Responsible for producing clinically defensible analyses that may be used in legal dispute resolution, regulatory review, fraud investigations, and strategic decision-making.
  • Coordinates across multiple departments, providing authoritative veterinary insight requiring a licensed professional skillset.
  • Expected to expand medical capacity within the organization and serve as part of the continuity and succession plan for enterprise veterinary leadership.

All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following:

  • Comprehensive full medical, dental and vision Insurance
  • Basic Life Insurance at no cost to the employee
  • Company paid short-term and long-term disability
  • 12 weeks of 100% paid Parental Leave
  • Health Savings Account (HSA)
  • Flexible Spending Accounts (FSA)
  • Retirement savings plan
  • Personal Paid Time Off
  • Paid holidays and company-wide Wellness Day off
  • Paid time off to volunteer at nonprofit organizations
  • Pet friendly office environment
  • Commuter Benefits
  • Group Pet Insurance
  • On the job training and skills development
  • Employee Assistance Program (EAP)