ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.
The Hartford
Hartford, CT, United States
Risk Manager - KR07AE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future. Strong risk management is pivotal to the ongoin
Job Source: The HartfordBaystate Medical Center
Springfield, MA, United States
Baystate Health’s Clinical Risk Managers are an integral member of the healthcare team. As the Risk Manager , you will be responsible for identifying potential losses to the organization, both clinical and enterprise, developing and maintaining appropriate loss prevention policy and strategy. The primary function of the Clinical Risk Manager
Job Source: Baystate Medical CenterBaystate Health
Springfield, MA, United States
Baystate Healths **Clinical Risk Managers** are an integral member of the healthcare team. As the Risk Manager _,_ you will be responsible for identifying potential losses to the organization, both clinical and enterprise, developing and maintaining appropriate loss prevention policy and strategy. The primary function of the Clinical Risk Manag
Job Source: Baystate HealthHartford HealthCare Medical Group
Hartford, CT, United States
Description Job Schedule: Full Time Standard Hours: 40 Job Shift: Shift 1 Shift Details: Monday-Friday Work where every moment matters. Every day, almost 30,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most com
Job Source: Hartford HealthCare Medical GroupSwiss Re
Windsor, CT, United States
About the Role This Claims Expert position is responsible for the processing of all levels of claims from low touch to complex claims, with the vast majority being complex claims, including responsibility for customer service and the financial risk associated with an assigned block of Stop Loss claims. Additional responsibilities include: Review
Job Source: Swiss ReBaystate Health
Springfield, MA, United States
Req#: R29846 Category(s): Legal/Compliance/Risk, Risk Full Time / Part Time: Full-Time Shift: First Baystate Health’s Clinical Risk Managers are an integral member of the healthcare team. As the Risk Manager , you will be responsible foridentifying potential losses to the organization, both clinical and enterprise, developing and main
Job Source: Baystate HealthNational Financial Partners
West Hartford, CT, United States
Who We Are NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Diversity, Equity and Inclusion (DEI) award from Insurance Business magazine and the WORK180 employer endorsement. We're a recognized Elite Agency award winner and a leading property and casualty broker, benefits consultant, wealth
Job Source: National Financial PartnersThe Travelers Indemnity Company
Hartford, CT, United States
Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine lov
Job Source: The Travelers Indemnity CompanyWindsor, CT, United States
We have an excellent opportunity for an experienced Clinical Risk Nurse Consultant to join our team in Swiss Re's Accident & Health division!
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.
In this position you have the responsibility to use your knowledge and experience to project expected treatment costs based on ICD 9 / ICD 10 codes, current treatment plan and other pertinent medical information.
Principal responsibilities include:
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 Dx, 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, Equity, and Inclusion are a part of our winning culture. We believe that our individual performances contribute to the success of the team. Come join us and be a part of something big!
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.
Additional requirements include:
Bachelor's degree in nursing with current state licensure and at least 3-5 years of clinical experience
Able to demonstrate a track record of producing work that is highly accurate, shows attention to detail, and reflects well on the organization
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.
About Swiss Re Corporate Solutions
Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer. We anticipate and manage risks, from natural catastrophes and climate change to cybercrime.
Swiss Re Corporate Solutions is the commercial insurance arm of the Swiss Re Group. We offer innovative insurance solutions to large and midsized multinational corporations from our approximately 50 locations worldwide. We help clients mitigate their risk exposure, whilst our industry-leading claims service provides them with additional peace of mind.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. Swiss Re Corporate Solutions embraces 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. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.
Swiss Re is an equal opportunity employer. It is our practice to recruit, hire and promote without regard to race, religion, color, national origin, sex, disability, age, pregnancy, sexual orientations, marital status, military status, or any other characteristic protected by law. Decisions on employment are solely based on an individual's qualifications for the position being filled.
During the recruitment process, reasonable accommodations for disabilities are available upon request. If contacted for an interview, please inform the Recruiter/HR Professional of the accommodation needed.
Keywords:
Reference Code: 128753
#J-18808-Ljbffr
Clinical Risk Manager (Hybrid Work Model) jobs in Windsor, CT, United States
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.