Clinical Risk Manager, C&F Stop Loss

Role Overview:

• Utilize advanced nursing and medical knowledge to evaluate clinical risk for stop loss insurance products.
• Provide accurate cost projections and savings opportunities to support underwriting decisions.

Key Responsibilities:

• Review and analyze medical data, diagnoses, and treatment plans to assess validity and clinical risk.
• Triage underwriting requests, apply evidence-based criteria, and act as a strategic partner to underwriting.
• Manage client relationships, ensure data integrity, and participate in quality assurance activities.

Qualifications:

• 5-10 years clinical experience with current unrestricted RN licensure preferred.
• 6+ years of reinsurance or insurance industry experience required.
• Bachelor's degree and strong PC skills including Excel required.

What We Offer:

• Flexible work arrangements and competitive compensation with a base salary range of $67,900 to $127,600.
• Generous 401(k) employer match, Employee Stock Purchase plan, and excellent benefits including health, dental, and vision.
• Tuition reimbursement, industry certifications, and professional training opportunities for career development.