Job Summary
A company is looking for a Stop Loss Risk Clinician.
Key Responsibilities
- Provide clinical support for the stop loss team
- Review and evaluate medical claims for appropriateness and compliance
- Collaborate with other healthcare professionals to ensure optimal patient care
Required Qualifications
- Registered Nurse (RN) license required
- Experience in clinical settings, preferably in risk management or stop loss
- Knowledge of medical terminology and healthcare regulations
- Ability to work part-time in a remote environment
- Relevant certifications in risk management or related fields are a plus
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