Seeking licensed nurse with clinical experience to evaluate potential risk and project expected claim costs based on ICD 9 / ICD 10 codes, current treatment plan, and other pertinent medical information.

*** Review and assess large claim reports, shock claim summary reports, trigger reports, and large case management notes for medical conditions and respond with a cost analysis.

*** Utilize reputable clinical resources such as Predict Dx, NCCN, NORD, and CDC.

*** Identify high risk associated with individuals and communicate required stop loss cost analyzation of current clinical conditions and ongoing cost projections.

*** Complete cost projections on new and renewal business within 24-48 hours of receipt.

*** Document clinical summary and estimated cost of care for each individual identified as at risk.

Fast paced and growth oriented organization offers a competitive compensation package, comprehensive health care plan, bonuses, 401(k) with company match, generous vacation time, numerous professional development opportunities, and more!

For details contact Mason Ingling at:
(609) 584-9000 ext 239

Or submit resume online at:
http://dmc9.com/mpi/app.asp

Or email to:
1000033552_10007348@jobbank303.com

Please reference #37995224 when responding.

5+ years

Massachusetts

$70,000.00

$130,000.00

Mason Ingling

(609) 584-9000 ext 239

1000033552_10007348@jobbank303.com

http://dmc9.com/mpi/app.asp

WE ARE AN EQUAL OPPORTUNITY EMPLOYER and our employment decisions are made without regard to race, color, religion, age, sex, national origin, handicap, disability or marital status. We reasonably accommodate individuals with handicaps, disabilities and bona fide religious beliefs. Jobs Career Position Hiring. CONSIDERED EXPERIENCE INCLUDES: http://najobbank.com www.najobbank.com Top 10 Job Site Top 10 Careers Site Insurance Clinical Risk Management Registered Nurse Physicians Assistant Risk Assessment Risk Analysis Medical Claims Stop Loss Claims

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