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Clinical Risk Specialist Jobs (NOW HIRING)

Captive Resources

Clinical Risk Specialist RN

Itasca, IL

$137K - $150K/hr

The Clinical Risk Specialist RN is responsible for providing high quality case management and claims management consulting, including identification, assessment and projections of high-cost cases to ...

Captive Resources

Clinical Risk Specialist RN

Itasca, IL

$137K - $150K/hr

The Clinical Risk Specialist RN is responsible for providing high quality case management and claims management consulting, including identification, assessment and projections of high-cost cases to ...

BayCare Health System

Risk Specialist

Clearwater, FL · On-site

$90K/yr

... and clinical excellence. Title: Risk Specialist Facility: Hybrid schedule requiring travel ... throughout BayCare hospital facilities as needed. This position requires Level II screening through ...

BayCare Health System

Risk Specialist

Clearwater, FL · On-site

$90K/yr

... and clinical excellence. Title: Risk Specialist Facility: Hybrid schedule requiring travel ... throughout BayCare hospital facilities as needed. This position requires Level II screening through ...

Bannerhealth

Risk Program Manager

Phoenix, AZ · Hybrid

The Clinical Risk Management team prides itself on the ability to value diverse input and ... While the Risk Manager may be responsible for the functions in the Risk Specialist , this position ...

Bannerhealth

Risk Program Manager

Tucson, AZ · Hybrid

The Clinical Risk Management team prides itself on the ability to value diverse input and ... While the Risk Manager may be responsible for the functions in the Risk Specialist , this position ...

Colorado Psychiatric

$25.75 - $34.50/hr

As a Clinical Risk Adjustment Documentation Specialist, this individual will play a critical role in supporting coding accuracy, HCC capture, regulatory compliance, and clinical documentation ...

New

Sustainable World, Inc.

$25.75 - $34.50/hr

As a Clinical Risk Adjustment Documentation Specialist, this individual will play a critical role in supporting coding accuracy, HCC capture, regulatory compliance, and clinical documentation ...

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Clinical Risk Specialist information

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$30K

$69.5K

$121K

How much do clinical risk specialist jobs pay per year?

As of Sep 11, 2026, the average yearly pay for clinical risk specialist in the United States is $69,454.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,000.00 and $83,000.00 per year, depending on experience, location, and employer.

What is a clinical risk specialist?

Clinical Risk Specialists are healthcare professionals responsible for identifying, assessing, and mitigating risks within clinical settings to improve patient safety and minimize liability. They analyze incidents, review processes, and collaborate with staff to develop strategies that prevent errors and adverse events. These specialists also lead training initiatives and ensure compliance with regulatory standards related to risk management. Their work is essential in creating a safe environment for both patients and healthcare providers.

What are some of the common challenges clinical risk specialists face when working with multidisciplinary healthcare teams?

Clinical Risk Specialists often navigate complex communication dynamics while collaborating with physicians, nurses, administrators, and support staff. Balancing differing perspectives on patient safety, regulatory compliance, and risk management strategies can be challenging, especially when introducing new policies or corrective actions. Success in this role requires strong interpersonal skills, diplomacy, and the ability to translate risk data into actionable insights that resonate with diverse team members. Establishing trust and fostering an open dialogue are key to effectively mitigating clinical risks and driving organizational improvements.

What are the key skills and qualifications needed to thrive as a clinical risk specialist, and why are they important?

To excel as a Clinical Risk Specialist, you need a solid background in healthcare risk management, regulatory compliance, and incident investigation, typically supported by a degree in nursing, health administration, or a related field. Familiarity with risk management information systems (RMIS), root cause analysis tools, and certifications like CPHRM (Certified Professional in Healthcare Risk Management) is often required. Strong analytical thinking, attention to detail, and effective communication skills are vital for proactively identifying risks and collaborating with clinical teams. These competencies help minimize liability, enhance patient safety, and ensure organizational compliance with healthcare regulations.

What is the difference between Clinical Risk Specialist vs Clinical Risk Coordinator?

AspectClinical Risk SpecialistClinical Risk Coordinator
CertificationsRisk management, healthcare compliance certificationsRisk management, healthcare compliance certifications
Work EnvironmentHospitals, clinics, healthcare organizationsHospitals, clinics, healthcare organizations
Employer & Industry UsageUsed in healthcare risk management teamsUsed in healthcare risk management teams
Search & Comparison IntentUnderstanding roles in healthcare risk managementUnderstanding roles in healthcare risk management

The Clinical Risk Specialist and Clinical Risk Coordinator roles share similar certifications and work environments, often found within healthcare organizations focusing on patient safety and risk mitigation. The main difference lies in scope: Clinical Risk Specialists typically focus on analyzing and managing complex risk issues, while Clinical Risk Coordinators handle the coordination of risk management activities and compliance efforts. Both roles are essential in healthcare risk management teams, but their responsibilities differ in focus and level of specialization.

Is healthcare risk management a good career?

A career as a Clinical Risk Specialist involves identifying and mitigating patient safety risks within healthcare organizations. It requires strong analytical skills, knowledge of healthcare regulations, and often certification such as Certified Professional in Healthcare Risk Management (CPHRM). The field offers opportunities for advancement and contributes to improving patient care quality.

What cities are hiring for Clinical Risk Specialist jobs?

Cities with the most Clinical Risk Specialist job openings:

What states have the most Clinical Risk Specialist jobs?

States with the most job openings for Clinical Risk Specialist jobs include:

What are popular job titles related to Clinical Risk Specialist jobs?

For Clinical Risk Specialist jobs, the most frequently searched job titles are:

Clinical Risk Specialist jobs near you

Clinical Risk Specialist RN

Itasca, IL

Captive Resources
Insurance Services • 51 - 200 employees
Learn more about Captive Resourcesexternal

$137K - $150K/hr

Full-time

Re-posted 25 days ago

Job description

The Clinical Risk Specialist RN is responsible for providing high quality case management and claims management consulting, including identification, assessment and projections of high-cost cases to assist in the underwriting process.

ESSENTIAL EDUCATION AND EXPERIENCE: ASN or BSN in nursing licensed in the State of Residence; at least two (2) years of clinical experience, AND at least two (2) years of stop loss or health payer experience.

SKILLS/COMPETENCIES REQUIREMENTS:

  • Reviewing stop-loss cases, making recommendations on potential cost of care, including lasers recommendations.
  • Use established guidelines when conducting stop-loss case reviews.
  • Works with underwriting team to identify potential high-risk claimants in new business and renewal groups.
  • Elicits support from sales and account management, and underwriting.
  • Use reporting and risk identification tools on medical and pharmacy claims to assess risk.
  • Assists in responding to inquiries from underwriting and sales for additional information on large claimants.
  • Review of monthly TPA reporting on current business for reserving.
  • Understanding of health and prescription costs.
  • Understanding of health delivery systems and professionals.
  • Understanding of disease life cycle, disease progression, expected health outcomes based on standard, accepted care management principles.
  • Understanding of stop loss reporting tools and requirements preferred.
  • Understanding of risk mitigation, high claimant detection, engagement and management preferred.
  • Requires strong interpersonal skills with a demonstrated ability to work across divisions and with external stakeholders.
  • Requires proficiency in the use of MS Office, AMS product suite, and ESL Office (Connexure/David Young).

TRAVEL: Occasional travel may be required for meetings, conferences, or client visits. This includes compliance with all of the requirements of the localities and destinations, as well as transportation carrier requirements.

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