Clinical Risk Manager Jobs in Oregon (NOW HIRING)

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The opportunity

The Associate Director, Clinical Services leads a staff of Registered Professional Nurses (RN's) and Clinical Underwriting Team to ensure accurate and timely clinical reviews in conjunction with an eye to assure optimization of health, risk mitigation, and support of our internal and external clients in understanding of disease processes and the potential treatment needs of the same.

How you will contribute:

Manage professional staff to:

Provide accurate and timely consultation on referrals from the Underwriting team and other internal clients

Identify members who could benefit from additional resources like Clinical 360 cost containment measures

Optimize both risk and health outcomes

Drive team performance and growth:

Conduct regular Quality Assurance (QA) reviews and provide coaching

Set performance goals and conduct reviews using appropriate tools

Offer career development and training opportunities

Make key personnel decisions (hiring, terminations, promotions, salary increases)

Foster innovation and collaboration:

Support staff in identifying and implementing innovative solutions

Build collaborative relationships within the Underwriting organization

Facilitate partnerships across the broader Health and Risk solutions claims organization

Lead strategic initiatives:

Contribute to special projects and change management activities

Promote the company's philosophy, strategies, and business objectives

Develop an interdisciplinary clinical model aligned with business needs

Maintain operational excellence:

Manage operating expenses within budget

What you will bring with you:

Ability to work with a diverse range of people.

Experience Registered Nurse (RN) with 3-5 years' experience in Stop Loss or similar financial/insurance field.

Experience in Clinical UW for Stop Loss or similar financial or health products.

Registered Nurse in Good standing, additional certifications a plus

High level of medical expertise and business knowledge of claims risk management

Demonstrated ability to coach and develop others

Able to solve problems that don't have clear solutions or outcomes

Strong analytical and critical thinking skills

Strong project management and organizational skills

Collaborative and comfortable in cross functional organizations

Excellent communication skills

Salary $101,000 - $151,500

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.comto request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.