Maine Licensed Clinical Risk Manager

Job Summary

A company is looking for a Clinical Risk Manager to evaluate and manage stop loss claims.

Key Responsibilities:

• Review and analyze clinical data to assess potential stop loss claim liabilities
• Provide cost projections on high-dollar claimants to support underwriting decisions
• Utilize case management techniques to ensure effective cost containment and management of high-risk claims

Required Qualifications:

• Associate or Bachelor's degree in Nursing or a related field is preferred
• At least 3 years of clinical experience, with a minimum of 1 year in stop loss nursing or clinical risk management
• Current and valid Registered Nurse (RN) license