Clinical Risk Manager
Swiss Re · Windsor, Connecticut, US
Swiss Re uses a hybrid work model requiring at least three days in the office each week. This position can be based near one of our Swiss Re offices, includi...
Job description
Swiss Re uses a hybrid work model requiring at least three days in the office each week. This position can be based near one of our Swiss Re offices, including (but not limited to) Alpharetta, GA -- Windsor, CT -- Schaumburg, IL. We have an excellent opportunity for an experienced Clinical Risk Manager 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 rep...