Clinical Risk Manager Jobs in Racine, WI (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 team of Registered Professional Nurses and clinical professionals responsible for operationalizing Sun Life's Health Care Capabilities. This role ensures the team effectively connects clients, brokers, and members to clinical programs, health navigation resources, and partner solutions designed to improve access to care, support better health outcomes, and help clients manage health care costs more effectively.

This position provides leadership, operational oversight, and relationship support for the clinical team responsible for bringing Sun Life Health Care Capabilities to life for clients, brokers, and members.

How you will contribute:

Essential functions and responsibilities include, but are not limited to, the following:

• Manage a professional clinical team responsible for consulting with internal partners, clients, and brokers to identify opportunities where Sun Life Health Care Capabilities can support members, improve access to care, and help clients achieve better financial and health outcomes.
• Lead the team in identifying members and client populations that may benefit from Sun Life Health Care Capabilities, including Clinical 360, Clinical 360+, care navigation, specialty care support, and other solutions that optimize health and reduce avoidable costs.
• Monitor Quality Assurance (QA) reviews regularly and provides staff coaching related to quality measures and feedback.
• Sets performance goals to drive individual performance; reviews staff through the use of performance review tools and provides regular coaching and performance, growth and developmental feedback.
• Provides career development and training opportunities. Makes decisions on personnel actions such as hiring, terminations, promotions, salary increases.
• Supports individuals in the identification and implementation of innovative solutions or efficiencies.
• Creates collaborative relationships across Distribution, Client Services, Product, Claims, Operations, vendor partners, and other Health and Risk Solutions teams to support a coordinated service model for clients and brokers.
• Serves as a leading contributor to special projects, operational readiness, and change management activities that advance Sun Life's health capabilities strategy, improve broker and client engagement, and support measurable outcomes.
• Understands client, broker, member, and business needs and fosters an interdisciplinary clinical operating model that connects clinical expertise, relationship management, and health capability execution.
• Develops and reinforces servicing approaches that clarify roles, improve response consistency, and strengthen broker and client confidence in Sun Life's ability to deliver health-focused value.
• Maintains operating expenses within budget.
• Ensures Key Performance Indicators are met.
• Other duties as assigned.

What you will bring with you:

• Experienced Registered Nurse (RN) or clinical professional in good standing, additional certifications a plus.
• 3-5 years' experience in clinical operations, health care navigation, health solutions, employee benefits, stop loss, or a similar health care or insurance-related field.
• High level of clinical expertise and business knowledge related to health care delivery, client service, member engagement, cost containment, and health outcomes.
• Demonstrated ability to coach and develop others.
• Demonstrated ability to achieve results through staff.
• 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.
• Demonstrated ability to build trusted relationships with client-facing teams, brokers, clients, vendor partners, and cross-functional stakeholders.
• Excellent communication skills, written and oral.
• Proven ability to influence sales partners in adopting our health strategies.
• Ability to analyze data to identify trends and opportunities.

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.