Clinical Risk Consultant

About the role

Provide analytical and consultative stop loss support to Alliant service teams and clients. Work closely with Stop Loss/MGA practice leadership. Support renewal conversations with clients and vendors. Provide ongoing cost containment identification and evaluation support to clients.

Essential Duties And Responsibilities

• Conduct research, review clinical notes, and prepare claims data loss analysis to provide actionable recommendations for clients and prospects.
• Responsible for Alliant’s proprietary Plan IQ predictive risk tool maintenance and reporting.
• Leverage systems to develop reporting to monitor and proactively report on group risk, identify cost impact, and partner with service teams to develop solutions for upcoming client renewals.
• Lead and/or support discussions regarding stop loss renewal and cost containment.
• Market clients’ self-funded group benefit plans to offer the most competitive stop loss insurance renewal and options.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience
• Ten (10) or more years’ experience within the insurance industry, including handling stop loss, high cost claims, and cost containment for self-funded group health plan clients
• Experience in a clinical background
• Experience in providing consultation to plan sponsors of employee group benefit plans
• Preferred: Experience with loss containment

Skills

• Strong knowledge of stop loss insurance, self-funded group insurance, cost containment, and vendor selection
• Strong knowledge of state and federal regulations impacting employer provided group health insurance
• Strong knowledge of regulatory reporting and tax consequences for self-funded plans
• Familiarity with vendor selection best practices
• Strong communication skills, both verbal and written
• Ability to analyze complex information and develop plans to address identified issues
• Ability to work collaboratively and build strategic relationships with others
• Ability to work and thrive in a fast-paced, dynamic environment with frequent interruptions, distractions, and a fluctuating workload

Benefits

We are proud to provide comprehensive, high quality employee programs to meet employees' needs now and in the future, including a very competitive financial package. We encourage you to explore what we have to offer.