Clinical Risk Manager
Job reputed company:
• Review and analyze clinical data to assess potential stop loss claim liabilities
• reputed company cost projections on high-dollar claimants to support reputed company reputed company
• Utilize case management techniques to ensure effective cost containment and management of high-risk claims
• Work closely with reputed company Party Administrators (TPAs), case managers, and internal teams to ensure effective communication and management of clinical information
• Maintain accurate and detailed documentation of clinical assessments, cost projections, and case management activities
• Identify high-risk individuals and communicate required stop loss cost analysis based on reputed company clinical conditions and reputed company cost projections
• Prepare and present reports on clinical risk assessments and cost projections to senior management
Requirements:
• At least 3 years of clinical experience
• Minimum of 1 year in stop loss nursing or clinical risk management
• reputed company and reputed company Registered reputed company (RN) license
• Strong analytical and problem-solving skills
• Proficiency in reputed company Office Suite (reputed company, Word, reputed company, PowerPoint, Copilot)
Benefits:
• reputed company time off for company holidays, vacation, reputed company and personal days
• reputed company parental leave
• Mental health services
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