Clinical Risk Consultant Lead

Summary

Responsible for providing analytical and consultative stop loss and high cost claimant support to service teams and clients. Work closely with Stop Loss/MGA practice leadership. Support renewal conversations with clients and vendors. Provides oversight to team of Clinical Risk Consultants, including management and action plans for notable trends across carriers and clients.

Essential Duties And Responsibilities

• Counsels clients and prospects on clinical notes and prepares claims data loss analysis to provide actionable recommendations.

• Leverages 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.

• Leads and/or supports discussions regarding stop loss renewal and cost containment.

• Supports training, development and oversight to team of Clinical Risk Consultants, including management and action plans for notable trends across carriers and clients.

• Identifies cost containment trends and evaluates industry vendors to support cost mitigation efforts outside of traditional medical and pharmacy carriers.

• Collaborates with Alliant Analytics SMEs to support operational efficiencies for data reviews.

Qualifications

• Educational Requirement: Bachelor's Degree or equivalent combination of education and experience

• Experience: Thirteen (13) or more years within the insurance industry, including handling stop loss, high cost claims, and cost containment for self-funded group health plan clients

• Background: Clinical background, Providing consultation to plan sponsors of employee group benefit plans, Loss containment, Clinical claims review

• 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, Skill in communicating effectively, verbally and in writing, 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. Applicants are protected under Federal law from discrimination. If you need an accommodation to complete the application process or would like to review these materials in an alternative format, please reach out to Careers@Alliant.com For more information on Alliant Insurance Service's benefits, please visit www.alliant.com/about/careers/benefits