South Carolina Licensed Stop Loss Nurse

Job Summary

Evaluating and managing catastrophic episodes of illness, the full-time South Carolina Licensed Stop Loss Nurse will provide case management oversight, facilitate cost estimates for underwriting, and consult on claims, all while working remotely.

Key responsibilities

• Facilitates cost estimates to underwriters for new and renewal stop loss business
• Consults with underwriters on catastrophic episodes of illness and provides case management oversight
• Reviews potential claim notices and excess claims to determine reserve settings and evaluates cost containment

Required qualifications

• Associates degree in a job-related field or graduate of an accredited school of nursing
• 10 years of work experience, including 5 years in clinical settings and 5 years in medical management
• Active RN licensure in the state of South Carolina
• Working knowledge of managed care and healthcare delivery systems
• Proficiency in Microsoft Office software