Summary
 

We are currently hiring for a Stop Loss Registered Nurse to join PACE Underwriters, A Division of Companion Life Insurance Company, located in Carrollton, TX. In this role, a Stop Loss Registered Nurse will evaluate and manage catastrophic episodes of illness for underwriting and claims. You will also ensure that the insured is receiving the best medical care, but in the most cost-effective manner.

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description
 

Logistics

This position is full time (40 hours/week) Monday-Friday and will be fully remote (W@H).

What You’ll Do:

• Facilitates cost estimates to the underwriters for new and renewal stop loss business.

• Consults with the underwriters on catastrophic episodes of illness.

• Provides Case Management oversight of Managed Care between the TPA and us.

• Review potential claim notices and excess claims received to determine setting reserves.

• Reviews potential claims notices from TPAs.

• Research as necessary to evaluate cost containment and intervenes with the TPA.

To Qualify for This Position, You’ll Need the Following:

• Associates in a job-related field.

• Graduate of Accredited School of Nursing.

• 10 years of experience (five years clinical plus five years medical management experience).

• Working knowledge of word processing software.

• Excellent verbal and written communication skills.

• Ability to work independently, prioritize effectively, and make sound decisions.

• Working knowledge of Managed Care and various forms of health care delivery systems.

• Working knowledge of catastrophic claims cost, medical vendors, case management.

• Demonstrated customer service, communication, and organizational skills.

• Analytical OR critical thinking skills.

• Ability to handle confidential OR sensitive information with discretion.

• Microsoft Office.

• Active RN licensure in state hired.

We Prefer That You Have the Following:

• Bachelor's degree – Nursing.

• 10 plus years as a medical staff nurse.

• Experience working with a stop loss carrier and providing underwriting and claims with medical cost projects.

• Five years of Case Management/Managed Care Experience.

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

• Subsidized health plans, dental, and vision coverage.

• 401K retirement savings plan with company match.

• Life Insurance.

• Paid Time Off (PTO).

• On-site cafeterias and fitness centers in major locations.

• Education Assistance.

• Service Recognition.

• National discounts to movies, theaters, zoos, theme parks and more.

What We Can Do for You

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What to Expect