Highmark Health
health care
10,000+ employees
Founded 1852
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
💰 $5M Grant on 2021-05
Excess Risk Managed Care Clinician
November 25
🇺🇸 United States – Remote
💵 $57.7k - $106.7k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
🎲 Risk
🦅 H1B Visa Sponsor
Highmark Health
health care
10,000+ employees
Founded 1852
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
💰 $5M Grant on 2021-05
Description
• Analyzing clinical data to assess potential stop loss and managed care claim liability • Utilizing Case Management oversight techniques for cost containment • Providing pre-sale and renewal support to underwriting and communications with TPA Case Managers • Building relationships with TPA Case Managers and CM/UM vendors
Requirements
• 5 years of any combination of clinical, case management, and/or disease/condition management experience • Experience in insurance industry with claim management preferable • Experience with excess risk product and related claim management/cost containment techniques • Experience with self-funding, Third Party Administration, and Managed Care
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