Registered Nurse Clinical Risk Consultant
Company: VirtualVocations
Location: Orange
Posted on: March 5, 2025
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Job Description:
A company is looking for a Senior Clinical Risk Consultant.
Key Responsibilities
Coordinate with management and teams to review medical claims for
appropriateness and identify cost-saving opportunities
Investigate and negotiate medical and prescription charges,
suggesting care alternatives and identifying billing errors
Review complex medical treatment plans for appropriateness and
coverage, and create educational presentations for various
audiences
Required Qualifications
Active Registered Nurse license
5+ years of clinical nursing experience
Preferred experience in Stop Loss insurance or 3+ years in Medical
in-depth case management
Strong knowledge of current medical conditions and treatment plans,
including organ transplantation and oncology
Independent analytical thinking and decision-making skills
Keywords: VirtualVocations, Orange , Registered Nurse Clinical Risk Consultant, Healthcare , Orange, California
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