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Director Stop Loss Rn Jobs (NOW HIRING)

Stop Loss Coordinator (Entry-Level) Our client, a growing organization within the insurance and ... Coordinate additional requirements, including nurse reviews when applicable * Assist the ...

Senior Medical Specialist- Stop Loss/HMO

MA · On-site

$107K - $127K/yr

Active, unrestricted RN license in state of residence. Experience : Minimum of 5 years of clinical ... Prior stop loss or HMO/PEI carrier experience required for senior position. Skills: * Ability to ...

The Stop Loss Product Manager will drive development and execution of Stop Loss product strategy ... Self-directed and self-motivated with ability to manage multiple projects, prioritize deliverables ...

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Director Stop Loss Rn information

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$55.5K

$108.7K

$170.5K

How much do director stop loss rn jobs pay per year?

As of Jun 5, 2026, the average yearly pay for director stop loss rn in the United States is $108,675.00, according to ZipRecruiter salary data. Most workers in this role earn between $83,000.00 and $125,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Director Stop Loss RN, and why are they important?

To thrive as a Director Stop Loss RN, you need extensive clinical nursing experience, a current RN license, and strong knowledge of stop loss insurance and healthcare risk management. Familiarity with claims adjudication systems, utilization review software, and relevant certifications such as CCM (Certified Case Manager) are highly beneficial. Leadership, analytical thinking, and effective communication are crucial soft skills for overseeing teams and collaborating with stakeholders. These skills ensure accurate risk assessment, efficient claims processing, and optimal financial and clinical outcomes for organizations.

What are some common challenges faced by a Director Stop Loss RN, and how can they be addressed?

A Director Stop Loss RN often encounters challenges such as balancing complex case reviews with administrative responsibilities, ensuring compliance with changing regulations, and effectively communicating with both clinical and non-clinical teams. Addressing these challenges requires strong organizational skills, continuous education on industry updates, and fostering open communication channels with underwriters, claims analysts, and healthcare providers. Prioritizing tasks and leveraging technology for data management can also help streamline workflows and enhance team collaboration.

What does a Director Stop Loss RN do?

A Director Stop Loss RN is a registered nurse who oversees and manages stop loss insurance programs within healthcare organizations. Their primary responsibility is to evaluate high-cost claims, coordinate care management, and ensure that stop loss coverage is effectively utilized to protect the organization from excessive financial losses. They also collaborate with clinical teams, insurers, and third-party administrators to optimize patient outcomes and cost containment strategies. Additionally, they may be involved in policy development, compliance, and reporting related to stop loss insurance.

What is the difference between Director Stop Loss Rn vs Stop Loss Nurse?

AspectDirector Stop Loss RnStop Loss Nurse
CredentialsRN license, industry certificationsRN license, specialized training
Work EnvironmentManagement, policy development, oversightPatient care, clinical support
Employer & IndustryInsurance companies, healthcare organizationsHospitals, clinics, insurance providers
Search & Comparison IntentLeadership roles in stop loss insuranceClinical roles related to stop loss coverage

The main difference is that the Director Stop Loss Rn focuses on managing stop loss insurance programs from a leadership and policy perspective, often overseeing teams and strategy. In contrast, the Stop Loss Nurse is primarily involved in clinical patient care and support within the stop loss insurance context. Both roles require RN credentials but serve different functions within the healthcare and insurance industries.

What cities are hiring for Director Stop Loss Rn jobs? Cities with the most Director Stop Loss Rn job openings:
What are the most commonly searched types of Stop Loss Rn jobs? The most popular types of Stop Loss Rn jobs are:
What states have the most Director Stop Loss Rn jobs? States with the most job openings for Director Stop Loss Rn jobs include:
Stop Loss Underwriting Specialist

Stop Loss Underwriting Specialist

Cambia Health Solutions

Renton, WA • On-site, Remote

$19.40 - $34.90/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 13 days ago


Cambia Health Solutions rating

8.4

Company rating: 8.4 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

102nd of 260 rated insurance


Job description

Stop Loss Underwriting Specialist

Work from home within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia's dedicated team of Stop Loss Underwriting Specialists are living our mission to make health care easier and lives better. The Stop Loss Underwriting Specialist supports the Stop Loss Underwriting team through data entry, running, and reviewing claims reports. This role is responsible for completing contracts and fee schedules and handling all administration of them. Additionally, they complete travel and expenses for stop loss director and team when applicable, and provide other administrative support as directed - all in service of creating an economically sustainable health care system.

Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

Stop Loss UW Specialist would have a High School diploma or GED and 4 years office, data entry or equivalent combination of education and experience, preferably in a health care environment. Knowledge of stop loss claims processing preferred.

Skills and Attributes:

  • Demonstrated ability to exercise sound judgment, initiative and discretion in a mature, sensitive and confidential manner.

  • Proven attention to detail and accuracy in data entry and other administrative tasks.

  • Computer skills including experience using Microsoft Office (Word, Excel, Outlook) or comparable software and ability to learn and use complex systems.

  • Ability to organize, prioritize and manage multiple tasks with little supervision.

  • Demonstrated ability to establish effective working relationships with coworkers and customers and to both work well independently and on a team.

  • Ability to communicate effectively both orally and in writing.

  • Knowledge of medical terminology, insurance billing and claims coding.

  • Demonstrated strong problem solving skills and ability to investigate and resolve complex issues.

  • Demonstrated ability to consistently meet productivity and quality standards with minimal support.

  • Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia:

  • Perform data input for all new stop loss cases and/or claims.

  • Enter all required fields to generate explanation of benefit forms and/or Stop Loss contracts and apply the appropriate fee schedule.

  • Run reports, review and analyze data and identify any areas of concern.

  • Run data downloads and reporting.

  • Review data and prepare management reports.

  • Understand Stop-Loss policy language and terms.

  • May assist with travel and completing expense reports.

The expected hiring range for a Stop Loss Underwriting Specialist is $19.40 - $26.80/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 6.25%. The current full salary range for this role is $19.40 - $34.90/hour.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:

  • Work alongside diverse teams building cutting-edge solutions to transform health care.
  • Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
  • Grow your career with a company committed to helping you succeed.
  • Give back to your community by participating in Cambia-supported outreach programs.
  • Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

  • Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
  • Annual employer contribution to a health savings account.
  • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
  • Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
  • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
  • Award-winning wellness programs that reward you for participation.
  • Employee Assistance Fund for those in need.
  • Commute and parking benefits.

Learn more about our benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.


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