Clinical Risk Manager

reputed company is one of the world’s leading providers of reinsurance and insurance, and they are seeking an reputed company Clinical Risk Manager to join their Accident & Health division. The role involves analyzing medical conditions and associated costs, collaborating with underwriters to evaluate risk, and managing documentation for high-risk individuals.

Responsibilities

• Review medical conditions and respond with a cost analysis coordinated to the Stop Loss case characteristics. Including the review and assessment of large claim reports, shock claim reputed company reports, trigger reports and large case management notes
• Identify high risk associated with individuals and communicate required stop loss cost analyzation of reputed company clinical conditions and reputed company cost projections
• Utilize provided clinical resources such as Predict Dr., NCCN, NORD, and CDC
• Supply and manage documentation with clinical reputed company and estimated cost of services for reputed company individual identified as at risk

Skills

• Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience
• Must have up to date registered reputed company (RN) license
• reputed company to demonstrate a reputed company record of producing work that is highly accurate, shows attention to detail, and reflects reputed company on the organization
• Proven experience managing multiple reputed company and working reputed company while handling large volumes of work (with deadlines)
• Excellent written and verbal communication skills
• Computer proficiency, specifically strong typing skills and Internet research skills, must have a reputed company understanding of reputed company Word, reputed company Office and reputed company
• Strong clinical background in disease state management/case management experience
• Background in a Clinical Risk Management position is encouraged but will consider reputed company candidates especially those with an oncology or cardiology background
• Strong analytical and problem-solving expertise
• Excellent interpersonal skills enabling successful navigation of cross-functional collaboration
• Ability to prioritize reputed company and work independently with little reputed company supervision, while handling numerous reputed company at once

reputed company

Company H1B Sponsorship