State Licensed Clinical Risk Analyst 3063621 I.Html
Job Description
To support effective case management, the full-time State Licensed Clinical Risk Analyst will review transplant and neonate cases, implement cost containment measures, and participate in medical underwriting while working remotely.
##### Key Responsibilities
Gather in-depth information from various sources to develop comprehensive case management plans
Determine objectives and actions to meet claimant needs and review available benefits at the reinsurance level
Educate internal staff and third-party administrators about Specialty Claims Unit services
##### Required Qualifications
Registered Nurse with an Associate's degree in Nursing (ADN) or Bachelor's degree in Nursing (BSN)
Strong medical knowledge, including ICD, CPT, medical terminology, COBRA, and HIPAA
Ability to apply knowledge of principles, practices, and procedures in clinical settings
Advanced organizational and analytical skills with the capacity to manage multiple tasks
Familiarity with industry changes and legal updates relevant to the insurance sector
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