Clinical Risk Consultant Lead

Alliant Insurance Services; Seattle (WA); On-site; USD 180,000 - 240,000; Full time

Job summary

Alliant Insurance Services seeks a senior professional to provide analytical and consultative stop loss support to service teams and clients. You will work with practice leadership to support renewals and oversee a team of Clinical Risk Consultants, driving insights and cost containment across carriers.

The role requires extensive experience in self-funded health plans, clinical claims review, and vendor evaluation, with a focus on actionable renewal strategies and client outcomes.

Qualifications

• Bachelor's Degree or equivalent combination of education and experience.
• Thirteen (13) or more years within the insurance industry, including handling stop loss, high cost claims, and cost containment for self-funded group health plan clients.
• Clinical background
• Providing consultation to plan sponsors of employee group benefit plans
• Loss containment
• Clinical claims review

Responsibilities

• Conducts research, review clinical notes, and prepare claims data loss analysis to provide actionable recommendations for clients and prospects.
• Leverages systems to develop reporting to monitor and proactively report on group risk, identify cost impact, and partner with service teams to develop solutions for upcoming client renewals.
• Leads and/or supports discussions regarding stop loss renewal and cost containment.
• Supports training, development and oversight to team of Clinical Risk Consultants, including management and action plans for notable trends across carriers and clients.
• Identifies cost containment trends and evaluates industry vendors to support cost mitigation efforts outside of traditional medical and pharmacy carriers.
• Collaborates with Alliant Analytics SMEs to support operational efficiencies for data reviews

Skills

Stop loss knowledge

Self-funded group health insurance

Cost containment

Vendor selection

Analytical communication

Team collaboration

Education

Bachelor's Degree or equivalent

Job description

At Alliant Insurance Services, we thrive on creating employee benefits solutions built on the idea that health makes growth possible. As top tier professionals dedicated to solving our clients' health and welfare insurance challenges, Alliant team members deliver an unrivaled depth of service, and our unique approach enables us to help clients stay resilient and turn change into opportunity. This position is a chance to join a dynamic, expanding company with prospects for individual and career growth.

As one of the 5 largest insurance brokerage firms in the U.S., Alliant provides property and casualty, workers' compensation, employee benefits, surety, and financial products and services to clients nationwide. More information is available at www.alliant.com.

SUMMARY

Responsible for providing analytical and consultative stop loss and high cost claimant support to service teams and clients. Work closely with Stop Loss/MGA practice leadership. Support renewal conversations with clients and vendors. Provides oversight to team of Clinical Risk Consultants, including management and action plans for notable trends across carriers and clients.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Conducts research, review clinical notes, and prepare claims data loss analysis to provide actionable recommendations for clients and prospects.
• Leverages systems to develop reporting to monitor and proactively report on group risk, identify cost impact, and partner with service teams to develop solutions for upcoming client renewals.
• Leads and/or supports discussions regarding stop loss renewal and cost containment.
• Supports training, development and oversight to team of Clinical Risk Consultants, including management and action plans for notable trends across carriers and clients.
• Identifies cost containment trends and evaluates industry vendors to support cost mitigation efforts outside of traditional medical and pharmacy carriers.
• Collaborates with Alliant Analytics SMEs to support operational efficiencies for data reviews

QUALIFICATIONS

EDUCATION / EXPERIENCE

• Bachelor's Degree or equivalent combination of education and experience
• Thirteen (13) or more years within the insurance industry, including handling stop loss, high cost claims, and cost containment for self-funded group health plan clients
• Clinical background
• Providing consultation to plan sponsors of employee group benefit plans
• Loss containment
• Clinical claims review

SKILLS

• Strong knowledge of stop loss insurance, self-funded group insurance, cost containment, and vendor selection
• Strong knowledge of state and federal regulations impacting employer provided group health insurance
• Strong knowledge of regulatory reporting and tax consequences for self-funded plans
• Familiarity with vendor selection best practices
• Skill in communicating effectively, verbally and in writing, as appropriate for the needs of the audience
• Ability to analyze complex information and develop plans to address identified issues
• Ability to work collaboratively and build strategic relationships with others
• Ability to work and thrive in a fast-paced, dynamic environment with frequent interruptions, distractions, and a fluctuating workload

We are proud to provide comprehensive, high quality employee programs to meet employees' needs now and in the future, including a very competitive financial package. We encourage you to explore what we have to offer.

Alliant Insurance Services, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment based on their qualifications and ability without regard to race, color, religion, sex (including pregnancy, childbirth, breastfeeding, sexual orientation, and gender identity), national origin, ancestry, physical or mental disability, medical condition, marital status, age, genetic information, or status as a protected veteran, in accordance with applicable federal, state, and local laws, including California law.

Applicants are protected under Federal law from discrimination. If you need an accommodation to complete the application process or would like to review these materials in an alternative format, please reach out to [e-mail]

For more information on Alliant Insurance Service's benefits, please visit www.alliant.com/about/careers/benefits