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Nursing Claims Manager

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Location
Oakbrook Terrace, IL
Salary
$100,000 - $120,000
Job Type
Direct Hire
Degree
Bachelor
Date
Jan 10, 2017
Job ID
2418416

POSITION OVERVIEW: Our client located in Oak Brook, IL is looking for a Nursing Claims Manager to help the underwriting and claims departments to identify exposure on large claims. The right candidate will collaborate with multiple clients, vendors, and staff to optimize the management of financial and medical risk. Candidates will ideally be local, but there is the possibility to work remotely for the right skills and experience.

You must currently live in the United States to be considered for this role. This is a direct hire position with no visa sponsorships available of any kind, and we do not work with any third party consulting firms.

RESPONSIBILITIES:

  • Provide subject matter expertise on high risk claims to medical management teams
  • Collaborate with partners to improve financial and clinical outcomes for claimants
  • Determine potential risk by analyzing underwriting information, medical information, and claim information
  • Analyze claim reports for cost optimization and case management opportunities

REQUIREMENTS:

  • Bachelor’s degree
  • RN License
  • Advanced to senior level health insurance experience
  • Moderate to advanced clinical experience
  • Stop Loss claim case manager experience

NICE TO HAVE SKILLS:

  • CCM Certification

This is a direct hire position with no visa sponsorships available, and we do not work with any third party consulting firms.

You must currently live in the United States to be considered for this role. Local candidates are preferred for this role because this company does not offer a relocation package, nor do they reimburse for travel expenses to the interview. Please consider that before applying.


Unless noted above, applicants MUST be authorized to work in the US without Visa Sponsorship. US citizens and Green Card holders ONLY. We do not provide relocation assistance for those living outside the continental US. Please only click apply if you meet the specific requirements of the job listing, you are able to work in the location listed, and are comfortable with the salary range indicated above. Thanks for your interest. We look forward to working with you.