Clinical Risk & Cost Optimization Lead

Ryan Specialty; United States; On-site; USD 104,000 - 120,000; Full time

Benefits offered by this job

Bonus eligibility

Competitive benefits

Job summary

Ryan Specialty Benefits is seeking an experienced Clinical Risk Manager to join our Clinical Advisory Team. This role blends clinical nursing expertise with financial analysis to identify high-cost claims, model costs, and develop mitigation strategies that influence underwriting and risk outcomes for clients.

You will partner with brokers, carriers, TPAs, and employer groups to implement cost containment, discuss treatment patterns, and present actionable risk insights to leadership.

Qualifications

• 3+ years of clinical nursing experience.
• 2+ years of stop loss captive risk management.
• Experience evaluating complex and catastrophic claims.

Responsibilities

• Analyze medical and pharmacy claims to identify high-cost exposure.
• Develop accurate clinical cost projections for complex cases.
• Collaborate with brokers, carriers, TPAs, and employers to mitigate costs.
• Present clinical risk insights to clients and leadership.
• Prepare reports and executive summaries on risk and financial impact.

Skills

Clinical risk management

Financial analysis

Collaboration & relationship mgmt

Education

Associate's or Bachelor's Degree in Nursing

Job description

Ryan Specialty Benefits is seeking an experienced Clinical Risk Manager to join our Clinical Advisory Team. This role blends clinical nursing expertise with financial analysis to identify high-cost claims, model costs, and develop mitigation strategies that influence underwriting and risk outcomes for clients.

You will partner with brokers, carriers, TPAs, and employer groups to implement cost containment, discuss treatment patterns, and present actionable risk insights to leadership.