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Maine Licensed Clinical Risk Manager
A company is looking for a Clinical Risk Manager to evaluate and manage stop loss claims. Key Responsibilities: Review and analyze clinical data to assess potential stop loss claim liabilities Provide cost projections on high-dollar claimants to support underwriting decisions Utilize case management techniques to ensure effective cost containment and management of high-risk claims Required Qualifications: Associate or Bachelor's degree in Nursing or a related field is preferred At least 3 years of clinical experience, with a minimum of 1 year in stop loss nursing or clinical risk management Current and valid Registered Nurse (RN) license Experience in oncology or cardiology is a plus
A company is looking for a Clinical Risk Manager to evaluate and manage stop loss claims.
Key Responsibilities:
Review and analyze clinical data to assess potential stop loss claim liabilities
Provide cost projections on high-dollar claimants to support underwriting decisions
Utilize case management techniques to ensure effective cost containment and management of high-risk claims
Required Qualifications:
Associate or Bachelor's degree in Nursing or a related field is preferred
At least 3 years of clinical experience, with a minimum of 1 year in stop loss nursing or clinical risk management
Current and valid Registered Nurse (RN) license
Experience in oncology or cardiology is a plus
