Clinical Risk Consultant

Job Summary

A company is looking for a Clinical Risk Consultant to provide analytical and consultative support for stop loss insurance and cost containment strategies.

Key Responsibilities

• Conduct research and prepare claims data loss analysis to provide actionable recommendations
• Maintain and report on the proprietary Plan IQ predictive risk tool
• Lead discussions regarding stop loss renewal and market clients' self-funded group benefit plans

Required Qualifications

• Bachelor's degree or equivalent combination of education and experience
• Ten or more years of experience in the insurance industry, particularly with stop loss and high cost claims
• Experience in a clinical background
• Experience providing consultation to plan sponsors of employee group benefit plans
• Experience with loss containment and clinical claims review preferred