Clinical Risk Manager
About the role
This position requires a strong clinical background in disease state management/case management experience. A background in a Clinical Risk Management position is encouraged but will consider qualified candidates especially those with an oncology or cardiology background. This position is ideal for applicants looking to enter the insurance sector in a nurse consultant role.
Principal 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 summary reports, trigger reports and large case management notes.
- Identify high risk associated with individuals and communicate required stop loss cost analyzation of current clinical conditions and future cost projections.
- Utilize provided clinical resources such as Predict Dr., NCCN, NORD, and CDC.
- Supply and manage documentation with clinical summary and estimated cost of services for each individual identified as at risk.
About The Team
The Clinical Risk team brings value to Swiss Re working in close collaboration with Underwriters to determine and evaluate potential risk and associated costs of projected treatments and care. We are a welcoming team of nurses who are passionate about what they do. Diversity and Inclusion are a part of our winning culture. We believe that our individual performances contribute to the success of the team.
About You
- You bring your strong analytical and problem-solving expertise!
- Your excellent interpersonal skills enable you to successfully navigate cross-functional collaboration.
- You have an ability to prioritize well and work independently with little direct supervision, while handling numerous projects at once.
- You have a minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience.
- You must have up to date registered nurse (RN) license.
- You are able to demonstrate a track record of producing work that is highly accurate, shows attention to detail, and reflects well on the organization.
- You have proven experience managing multiple projects and working well while handling large volumes of work (with deadlines).
- You have excellent written and verbal communication skills.
- You have computer proficiency, specifically strong typing skills and Internet research skills, must have a clear understanding of Microsoft Word, Microsoft Office and Excel.
Additional Requirements
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 nurse (RN) license
Able to demonstrate a track record of producing work that is highly accurate, shows attention to detail, and reflects well on the organization
Proven experience managing multiple projects and working well 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 clear understanding of Microsoft Word, Microsoft Office and Excel
Pay
The estimated base salary range for this position is $84,000 to $140,000. The specific salary offered for any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget.
About Swiss Re
Swiss Re is one of the world’s leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world. Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics.