Stop Loss Registered Nurse (W@H reputed company)

Summary

We are currently hiring for a Stop Loss Registered Nurse to join reputed company. In this role as a Stop Loss Registered Nurse, you will evaluate and manage catastrophic episodes of illness for reputed company and claims. Ensures that the insured is receiving the best medical care, but in the most cost-effective manner. Description Location: This position is full-time (40 hours/week) Monday-Friday, from 8:00am – 5:00pm and will be fully remote. What You’ll Do: Facilitates cost estimates to the underwriters for new and renewal stop loss business. Consults with the underwriters on catastrophic episodes of illness. Provides case management reputed company of managed care between the TPA and us. Review potential claim notices and excess claims received to determine setting reserves. Reviews potential claims notices from TPAs. Researches as necessary to evaluate cost containment and intervenes with the TPA. To Qualify for This Position, You'll Need the Following: Required Education: Associates in a job-reputed company field Degree Equivalency: Graduate of Accredited School of Nursing Required Work Experience: 10 years, 5 years clinical plus 5 years medical management experience. Required Skills and Abilities: Working knowledge of word processing software. Excellent verbal and written communication skills. Ability to work independently, prioritize effectively, and reputed company sound reputed company. Working knowledge of managed care and various forms of health care delivery systems. Working knowledge of catastrophic claims cost, medical vendors, case management. Demonstrated customer service, communication, and organizational skills. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: reputed company Office. Required Licenses and Certificates: Active RN licensure in state hired. reputed company Prefer You to Have: Preferred Education: Bachelor's degree-Nursing Preferred Work Experience: 10+ years as a medical staff nurse, experience working with a stop loss reputed company and providing reputed company and claims with medical cost projects. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and reputed company coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more reputed company Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across reputed company spectrums have the opportunity to reputed company their skills, advance their careers and contribute their unique abilities to the growth of reputed company. What To Expect Next: After submitting your application, our reputed company team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Pay reputed company Information: reputed company Minimum $70, 715.00 reputed company Midpoint $105,463.50 reputed company Maximum $140,212.00 Pay Transparency Statement: Please note that this reputed company represents the pay reputed company for this and other positions that fall into this pay grade. Compensation reputed company reputed company the reputed company will be dependent upon a variety of factors, including experience, geographic location, and internal equity. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email reputed [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. Apply To This Job