Clinical Risk Assessment Professional

2 weeks ago


Peabody, Kansas, United States National Financial Partners Corp. Full time
About the Role

National Financial Partners Corp. is a leader in the self-funded insurance market. We are currently seeking a highly skilled Clinical Risk Assessment Professional to join our team in Woodbury, NJ.

Job Summary

The successful candidate will be responsible for assessing claims and medical information to calculate potential risk, identifying claimants with catastrophic care needs, and providing written assessments within expected timeframes for use when establishing rates for new and renewal business.

Key Responsibilities

  • Assess claims and medical information to calculate potential risk
  • Identify claimants with catastrophic care needs
  • Research diagnoses, treatment plans, and average costs using varying resources
  • Analyze and interpret medical records, claims files, and underwriting reports
  • Communicate with underwriters and Senior Management to advise of potential claims involving significant risk
  • Investigate course of treatment for existing conditions

Requirements

  • Three or more years of clinical RN experience, preferably in a hospital setting
  • Two or more years of experience in the health insurance industry with in-depth knowledge of the UR and/or the case management process
  • Strong analytical, organizational, and decision-making skills and business orientation
  • Strong computer skills
  • Excellent written and verbal communication skills

What We Offer

National Financial Partners Corp. is proud to offer a competitive salary, PTO, and paid holidays, 401(k) with match, exclusive discount programs, health and wellness programs, and more. Our people-first culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others.



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