RN Licensed Associate Director

Job Summary

Providing clinical expertise and leadership for the Medical Management team, the full-time RN Licensed Associate Director will assess high-risk claims, educate stakeholders on clinical trends, and identify cost containment opportunities while working remotely from anywhere within the U.S.

Key responsibilities:

• Review and assess large claim notices for potential risk and monitor claimants for ongoing risk assessment
• Educate internal and external customers on clinical trends and research medical conditions to support treatment understanding
• Collaborate with various teams to identify and implement cost containment measures for claimants

Required qualifications:

• Current and unrestricted RN license in the state of residence
• 5+ years of clinical experience
• 4+ years of experience in the Stop Loss industry, TPA's, or managed care
• 2+ years of ER, critical care, or oncology experience
• Managerial experience with proficiency in Microsoft Excel