Clinical Risk Manager Position Available In [Unknown county], Maine

Clinical Risk Manager locations
Remote – Maine
time type
Full time
posted on
Posted 4 Days Ago
job requisition id

JR25-2250

Position Summary We are seeking a highly skilled and experienced stop loss Clinical Risk Manager to join our team. The ideal candidate will have a strong clinical background and expertise in evaluating and managing stop loss claims. This role involves analyzing clinical data, assessing potential risks, and providing cost projections to support our underwriting and risk management processes. What will your job entail?

Key Responsibilities:

Clinical Data Analysis:

Review and analyze clinical data to assess potential stop loss claim liabilities.

Cost Projections:

Provide cost projections on high-dollar claimants to support underwriting decisions.

Case Management Oversight:

Utilize case management techniques to ensure effective cost containment and management of high-risk claims.

Collaboration:

Work closely with Third Party Administrators (TPAs), case managers, and internal teams to ensure effective communication and management of clinical information.

Documentation:

Maintain accurate and detailed documentation of clinical assessments, cost projections, and case management activities.

Risk Assessment:

Identify high-risk individuals and communicate required stop loss cost analysis based on current clinical conditions and future cost projections.

Reporting:

Prepare and present reports on clinical risk assessments and cost projections to senior management.

Qualifications:

Education:

Associate or Bachelor’s degree in Nursing or a related field is preferred.

Experience:

At least 3 years of clinical experience, with a minimum of 1 year in stop loss nursing or clinical risk management.

Licensure:

Current and valid Registered Nurse (RN) license.

Skills:

Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Ability to work independently and manage multiple projects simultaneously.

Preferred:

Experience in oncology or cardiology is a plus.

Working Conditions:

Location:

Portland Maine, in office or remote work. Ryan Specialty is an Equal Opportunity Employer. We are committed to building and sustaining a diverse workforce throughout the organization. Our vision is an inclusive and equitable workplace where all employees are valued for and evaluated on their performance and contributions. Differences in race, creed, color, religious beliefs, physical or mental capabilities, gender identity or expression, sexual orientation, and many other characteristics bring together varied perspectives and add value to the service we provide our clients, trading partners, and communities. This policy extends to all aspects of our employment practices, including but not limited to, recruiting, hiring, discipline, firing, promoting, transferring, compensation, benefits, training, leaves of absence, and other terms, conditions, and benefits of employment. How We Support Our Teammates Ryan Specialty seeks to offer our employees a comprehensive and best-in-class benefits package that helps them — and their family members — achieve their physical, financial, and emotional well-being goals. In addition to paid time off for company holidays, vacation, sick and personal days, Ryan offers paid parental leave, mental health services and more. The target salary range for this position is $104,000.00 – $130,000.00 annually. The wage range for this role considers many factors, such as training, transferable skills, work experience, licensure and certification, business needs, and market demands. The pay range is subject to change and may be modified in the future. Full-time roles are eligible for bonuses and benefits. For additional information on Ryan Specialty Total Rewards, benefits.ryansg/. We provide individuals with disabilities reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment in accordance with applicable law. Please contact us to request an accommodation at HRRyansg The above is intended to describe this job’s general requirements. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. About Us Ryan Specialty is a leading international specialty insurance firm which offers wholesale brokerage services, delegated underwriting expertise in the form of binding authorities, programs and highly specialized managing general underwriting companies, and other services designed specifically for brokers, agents and insurers. Ryan Specialty’s mission is to be the most trusted trading partner of insurance brokers, agents and insurance carriers. Ryan Specialty, LLC and its affiliates (“Ryan Specialty”) do not accept unsolicited resumes or candidate profiles submitted by any staffing agencies, placement services, or professional recruiters (“Agencies”), including any submissions made through our website or to email accounts of Ryan Specialty employees. Agencies must obtain advance written approval from Ryan Specialty’s HR department to submit resumes and candidate profiles, and then only in conjunction with a valid, fully executed contract for service and in response to the particular search for which Ryan Specialty has engaged such Agency. Agency fee agreements will only be valid if in writing and signed by a member of Ryan Specialty’s HR team. No other Ryan Specialty employee is authorized to bind Ryan Specialty to any agreement regarding placement of candidates by any Agency. Any unsolicited resume or candidate profile received from an Agency without prior approval from Ryan Specialty’s HR department and in compliance with Ryan Specialty’s candidate submission process shall be considered unsolicited, gratuitous and property of Ryan Specialty for recruiting purposes and, as such, is not subject to payment of any Agency fees. Read More
Follow Us
© 2025 Workday, Inc. All rights reserved.