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Claims Risk Manager Jobs in Providence, RI (NOW HIRING)

FM

Accountant

Johnston, RI · On-site

$75K - $106K/yr

... risk management and the resilience of its policyholder-owners. These owners, who share the belief ... The individual will work closely with Underwriting, Claims, Treasury, Financial Reporting ...

FM

Accountant

Johnston, RI · On-site

$75K/yr

... risk management and the resilience of its policyholder-owners. These owners, who share the belief ... The individual will work closely with Underwriting, Claims, Treasury, Financial Reporting ...

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Claims Risk Manager information

See Providence, RI salary details

$35.4K

$88.8K

$140.4K

How much do claims risk manager jobs pay per year?

As of Sep 11, 2026, the average yearly pay for claims risk manager in Providence, RI is $88,760.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,700.00 and $106,100.00 per year, depending on experience, location, and employer.

What does a claims risk manager do?

A Claims Risk Manager is responsible for identifying, assessing, and managing risks associated with insurance claims within an organization. They analyze claims data to detect patterns, prevent fraudulent activity, and develop strategies to minimize financial losses. Additionally, they work closely with claims adjusters, legal teams, and other departments to ensure compliance with regulations and to optimize claims processes. Their goal is to protect the company from unnecessary losses while ensuring legitimate claims are handled efficiently.

What are the key skills and qualifications needed to thrive as a claims risk manager?

To thrive as a Claims Risk Manager, you need expertise in insurance claims processes, risk assessment, and regulatory compliance, typically backed by a bachelor’s degree in a relevant field and experience in claims management. Familiarity with claims management systems, risk modeling software, and certifications such as CPCU (Chartered Property Casualty Underwriter) or ARM (Associate in Risk Management) are often required. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claims and collaborate with stakeholders. These skills enable accurate risk evaluation, minimize losses, and ensure the organization’s compliance and financial stability.

How does a claims risk manager typically collaborate with other departments to minimize organizational risk?

A Claims Risk Manager works closely with departments such as underwriting, legal, compliance, and operations to identify potential risk exposures and implement effective mitigation strategies. They often participate in cross-functional meetings to review claims trends, share insights, and develop risk management policies. This collaborative approach ensures that the organization proactively addresses risks, maintains regulatory compliance, and continually improves claims processes for better outcomes.

What is the difference between Claims Risk Manager vs Claims Adjuster?

AspectClaims Risk ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree in risk management, insurance, or related field; certifications like CPCU or ARM are commonRequires a high school diploma or bachelor’s degree; insurance licenses may be needed depending on state
Work EnvironmentOffice-based, strategic planning, risk assessment, policy developmentField or office-based, investigating claims, assessing damages, negotiating settlements
Industry UsageUsed across insurance companies, risk management firms, and large corporationsPrimarily in insurance companies, adjusting claims for auto, property, or health insurance

The Claims Risk Manager focuses on identifying and mitigating risks related to claims, developing policies, and overseeing risk strategies. In contrast, a Claims Adjuster handles the day-to-day investigation and settlement of individual claims. Both roles are essential in the insurance industry but differ in scope and responsibilities.

How much do claims risk managers make in the US?

Claims risk managers in the US typically earn a median annual salary of around $80,000 to $100,000, with experienced professionals and those in senior roles earning over $120,000. Salaries vary based on location, industry, experience, and certifications such as CPCU or ARM.

Is Claims Risk Manager a good career?

A Claims Risk Manager oversees the assessment and mitigation of insurance claim risks, often requiring strong analytical skills and knowledge of insurance policies. The role offers opportunities for advancement and typically involves working in insurance, risk management, or corporate environments. It can be a stable and rewarding career for those interested in risk analysis and insurance processes.

What are popular job titles related to Claims Risk Manager jobs in Providence, RI?

For Claims Risk Manager jobs in Providence, RI, the most frequently searched job titles are:

What job categories do people searching Claims Risk Manager jobs in Providence, RI look for?

The top searched job categories for Claims Risk Manager jobs in Providence, RI are:

What cities near Providence, RI are hiring for Claims Risk Manager jobs?

Cities near Providence, RI with the most Claims Risk Manager job openings:

Claims Risk Manager jobs near you

Population Health Data Engineer

Providence, RI • On-site

Software Technology Inc
See more jobs at Software Technology Incexternal

$115K - $138K/yr

Full-time

Posted 13 days ago

Job description

Population Health Data Engineer

We are seeking a skilled Population Health Data Engineer with deep expertise in Epic data ecosystems and healthcare analytics. This role will focus on designing, building, and optimizing data pipelines and models to support population health, quality of care and claims analytics.

Key Responsibilities

  • Design, develop, and maintain scalable data pipelines supporting population health, claims analytics, and reporting.
  • Work extensively with Epic data sources including Registries, Rosters, Chronicles, Clarity, and Caboodle.
  • Integrate clinical and claims data to support longitudinal patient views and advanced analytics.
  • Develop data models for population health use cases including quality measures, risk stratification, utilization, and care management analysis.
  • Support development and operationalization of risk scoring data models and analytics (e.g., MARA, HCC, RAF).
  • Process and transform healthcare claims data (medical and pharmacy) for analytics and reporting.
  • Work with Milliman MedInsight data structures to support payer-provider analytics and efficiency benchmarking.
  • Build and optimize ELT pipelines using modern cloud platforms.
  • Collaborate with healthy planet, efficiency, quality, clinical, and analytics teams to translate business needs into technical solutions.
  • Ensure data quality, governance, and compliance with healthcare regulations (e.g., HIPAA).
  • Optimize performance of large-scale datasets and queries.

Required Qualifications

  • Strong hands-on experience with Epic systems, including:
    • Epic Registries
    • Chronicles data structures
    • Hyperspace or Hyperdrive environments
    • Clarity and Caboodle data models
  • Experience with modern data engineering tools and platforms:
    • Snowflake (data warehousing)
    • DBT (data transformation and modeling)
    • Dynamic Tables in Snowflake
  • Solid understanding of healthcare domain concepts, including population health and value-based care.
  • Experience with healthcare claims processing (medical and pharmacy claims).
  • Hands-on experience with Milliman MedInsight data models and analytics workflows.
  • Strong SQL and data modeling expertise.
  • Experience building and maintaining data pipelines.

Key Skills

  • Population Health & Risk Analytics
  • Healthcare Data Modeling (Clinical and Claims)
  • Epic Data Ecosystem Expertise
  • Snowflake & DBT
  • SQL & Performance Optimization
  • Data Governance & Compliance

Education & Experience

  • Bachelor's or Master's degree in Computer Science, Health Informatics, Data Engineering, or related field.
  • 6+ years of experience in data engineering, with strong preference for healthcare, payer, or population health analytics experience.

Apply