Health Risk Strategist (Registered Nurse)

BERKLEY TECHNOLOGY SERVICES; Sewickley (Allegheny County); Remote; USD 100,000 - 130,000; Full time

Job summary

A leading company in risk management is seeking a Health Risk Strategist (Registered Nurse) to join their team. This role involves evaluating health risk management developments, educating clients on solutions, and developing strategic plans to improve health outcomes. Ideal candidates will possess a Bachelor's Degree and a Registered Nurse license, along with relevant experience in clinical management and health risk strategies.

Benefits

Health, dental, vision insurance

401(k) and profit-sharing plans

Paid time off

Wellness programs

Annual discretionary bonus

Qualifications

• 3+ years of Clinical Health Risk/Stop Loss/Reinsurance experience.
• Detail oriented with strong time management skills.
• Ability to travel 10-20%.

Responsibilities

• Assist in development and implementation of strategic plans for Health Risk Management.
• Serve as a clinical resource to clients and identify new medical technologies.
• Review large claim events and provide options for medical management.

Skills

Analytical thinking

Communication

Negotiation

Time management

Problem solving

Education

Bachelor's Degree

Registered Nurse license

Tools

MS Word

Excel

Outlook

Job description

Company Details

Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we can help employers better manage their risk. We offer a broad range of products, including employer stop loss, benefit captives, provider stop loss, HMO reinsurance, and specialty accident. The key to Berkley’s success is our nimble approach to risk – our ability to quickly understand, think through, and devise a plan that addresses each client’s challenges, coupled with the strong backing of a Fortune 500 company. Our parent company, W. R. Berkley Corporation, is one of the largest and best managed property/casualty insurers in the United States.

The company is an equal employment opportunity employer.

Responsibilities

We have an opportunity for a Health Risk Strategist (Registered Nurse) to join our Berkley Accident and Health (BAH) team! This role keeps abreast of and evaluates new developments affecting Health Risk Management and Health Vendor resources (including Clinical, Claim and Population Health management). You will assist in the education of clients regarding leading health risk management/cost‐containment solutions. You will perform proactive reviews each year to identify risk “hot spots,” and recommend changes to improve overall health plan results.

We are open with location, including remote options

We have a welcoming culture valuingour employees – we trademarked the phrase Everything Counts, Everyone Matters to describe the Berkley commitment to our people and how we do business. We believe that every person in the organization is important and every accomplishment makes a difference in our results. Come join us!

Key functions include but are not limitedto:

• Assist in development and implementation of strategic plans for Berkley's Health Risk Management efforts to create market leadership and market distinction
• Serve as clinical resource to both internal/external clients, identify and communicate new medical /pharmacological technology impacting both BAH and clients
• Develop and perform needs assessment/gap regarding client’s Health Risk management/strategies through customer surveys and interactions to determine potential client needs
• Review potential/actual large claim events and provide internal/external options regarding medical management to minimize claims dollars without causing a negative effect on clinical outcomes
• Responsible for developing and coaching effective Health Risk Management strategy communications regarding claim/financial projections and rationale to both internal/external clients
• Report on BAH’s Health Risk Management program efficacy regarding external client acceptance and financial/service impact
• Foster strong relationships with external clients (Captives, Policyholders, TPA’s, external CM’s) and internal BAH resources (UW’s, Claims, Account Managers) through individual credibility; apply business acumen to communicate risk factors, resolve complex inquiries and develop recommendations for continuous improvement and alignment with overall BAH risk strategy
• Maintain HRM vendor management programs including: soliciting and interviewing potential vendors, assist in onboarding and implementation vendor relationship, review of vendor efficacy and recommend on-going or cancellation of vendor relationships

Qualifications

• Bachelor's Degree required with a Registered Nurse license
• 3+ years of either Clinical Health Risk/Stop Loss/Reinsurance experience
• 2-3 years progressively responsible clinical management/cost containment experience preferred
• Prefer to have at least one of the following: Advanced Achievement in Transplant Management (AATMC), Certification in Case ManagemeCCM(CCM), Certified Rehabilitation Registered NurCRRNCRRN), or Certified Professional in Utilization ManagemeCPUMCPUM) or American Association of Managed Care Nurses (AAMCN)
• Ability to work in a self-directed manner, and initiating and prioritizing regular work duties and projects; ability to think analytically, critically and problem solve with ability to demonstrate decision-making skills and develop strategic plans
• Detail oriented, organized, the ability to multi-task, and strong time management skills with the ability to meet deadlines and respond to unexpected requests in a prompt manner.
• Strong communication skills: written, verbal, interpersonal, customer service
• Solid mathematical skills, strong computer skills, proficient in PC environment with MS Word, Excel and Outlook
• Solid negotiation skills, confidentiality, discretion and tact being key skills
• Exemplify solid work ethic and positive attitude regarding working relationships with management and staff to further the BAH mission
• Maintain regular and predictable attendance with demonstrated ability to adapt to cyclical business needs
• Ability to travel 10-20%

Additional Company DetailsWe do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including: • Base Salary Range: $100,000 - $130,000 • Eligible to participate in annual discretionary bonus • Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Job Description

BAH Health Risk Strategist