New Jersey Licensed Clinical Risk Manager

Key responsibilities: Conduct comprehensive medical risk assessments and clinical evaluations to inform underwriting decisions Develop and implement clinical risk management strategies for high-cost claims, identifying cost-containment opportunities Maintain strong relationships with clients and stakeholders, ensuring exemplary customer service and addressing escalations as needed

Required qualifications: 6-10 years of clinical experience with current unrestricted licensure as a health professional (Registered Nurse) preferred 6+ years of experience in the reinsurance or insurance industry Bachelor's degree from an accredited university or equivalent experience required Strong knowledge of disease processes and treatment plans Proficient in Microsoft Excel, Word, and Outlook