New Jersey Licensed Clinical Risk Manager

Job Summary

A company is looking for a Senior Clinical Risk Manager (Remote).

Key Responsibilities

• Develop and implement advanced clinical risk management strategies for high-cost claims
• Analyze clinical and claims data to identify risks and engage cost containment strategies
• Maintain relationships with clients and stakeholders, providing support on case management and claims issues

Required Qualifications

• 5-10 years of clinical experience with current unrestricted licensure as a health professional (Registered Nurse)
• 5+ years of reinsurance or insurance industry experience required
• Bachelor's degree from an accredited university or equivalent experience required
• Strong PC skills including Excel, Word, and Outlook
• Knowledge of disease processes and treatment plans