Registered Nurse Clinical Risk Manager
Job Summary
Seeking an experienced Registered Nurse Clinical Risk Manager, the full-time remote position will manage clinical risk assessments, develop cost mitigation strategies, and collaborate with various stakeholders to enhance risk management outcomes.
Key responsibilities
- Analyze medical claims and treatment plans to identify high-cost claim exposure and assess clinical severity
- Develop clinical cost projections and conduct financial analyses to support underwriting and risk management decisions
- Collaborate with brokers and vendors to implement effective risk mitigation strategies and monitor ongoing claims
Required qualifications
- Associate's or Bachelor's Degree in Nursing or a related healthcare field preferred
- Minimum of 3 years of clinical nursing experience
- Minimum of 2 years of stop loss captive risk management experience required
- Experience evaluating complex and catastrophic claims strongly preferred
- Active and unrestricted Registered Nurse (RN) license
Complete Job Description
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