Clinical Risk Manager

Swiss Re; Alpharetta (GA); Hybrid; USD 84,000 - 140,000; Full time

Job summary

Swiss Re is seeking an experienced Clinical Risk Manager to join our Accident & Health division in Alpharetta, GA. This hybrid role requires strong clinical background in disease state and case management, with a preference for candidates with oncology or cardiology experience. The manager will analyze medical conditions, forecast costs, and communicate risk assessments effectively. Candidates must hold a valid RN license and demonstrate competence in managing multiple projects. Competitive salary offered, ranging from $84,000 to $140,000 based on experience and skills.

Qualifications

• At least 1 year of Stop Loss nursing experience required.
• Must have an up-to-date registered nurse (RN) license.
• Ability to handle large volumes of work and meet deadlines.

Responsibilities

• Review medical conditions and conduct cost analysis.
• Identify high risk individuals and communicate cost analysis.
• Utilize clinical resources for risk evaluation.

Skills

Analytical skills

Problem-solving expertise

Interpersonal skills

Detail-oriented

Project management

Communication skills

Education

Associate or Bachelor's degree in Nursing

Tools

Microsoft Word

Microsoft Office

Microsoft Excel

Job description

Swiss Re uses a hybrid work model requiring at least three days in the office each week. The position can be based near one of our Swiss Re offices, including Alpharetta, GA; Windsor, CT; or Schaumburg, IL.

About the Role

We are looking for an experienced Clinical Risk Manager to join our Accident & Health division. This role requires a strong clinical background in disease state management and case management experience. Experience in clinical risk management is encouraged, especially those with oncology or cardiology backgrounds. The position is ideal for applicants looking to enter the insurance sector in a nurse consultant role.

Principal Responsibilities Include

• Review medical conditions and conduct cost analysis coordinated to Stop Loss case characteristics, including large claim reports, shock claim summary reports, trigger reports, and large case management notes.
• Identify high risk associated with individuals and communicate required stop loss cost analysis of current clinical conditions and future cost projections.
• Utilize provided clinical resources such as Predict Dr., NCCN, NORD, and CDC.
• Supply and manage documentation with clinical summary and estimated cost of services for each individual identified as at risk.

About the Team

The Clinical Risk team works closely with Underwriters to determine and evaluate potential risk and associated costs of projected treatments and care. We are a welcoming team of nurses who are passionate about what they do.

About You

You bring strong analytical and problem‑solving expertise, excellent interpersonal skills, and the ability to prioritize well and work independently with little direct supervision while handling multiple projects at once.

Additional Requirements Include

• Minimum of an associate or bachelor’s degree in nursing with at least 1 year of Stop Loss nursing experience.
• Must have an up‑to‑date registered nurse (RN) license.
• Able to demonstrate a track record of producing highly accurate work with strong attention to detail.
• Proven experience managing multiple projects and working well while handling large volumes of work with deadlines.Excellent written and verbal communication skills.
• Computer proficiency; strong typing skills and internet research skills; clear understanding of Microsoft Word, Office, and Excel.

The estimated base salary for this position ranges from $84,000 to $140,000, based on factors including location, role scope, qualifications, and experience. Compensation is considered as a total package, encompassing base pay, short‑ and long‑term incentives, and benefits.