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Stop Loss Nurse Jobs (NOW HIRING)

Crum & Forster

Underwriter, C&F Stop Loss

Phoenix, AZ · On-site +1

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... Send large claims reporting for nurse review * Develop strategic relationships with sales, brokers ...

Cfins

$60 - $80/hr

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... nurse review * Develop strategic relationships with sales, brokers, third-party administrators ...

Crum & Forster

Underwriter, C&F Stop Loss

Phoenix, AZ · On-site

$60 - $80/hr

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... Send large claims reporting for nurse review * Develop strategic relationships with sales, brokers ...

Crum & Forster

Underwriter, C&F Stop Loss

Phoenix, AZ · On-site

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... Send large claims reporting for nurse review * Develop strategic relationships with sales, brokers ...

Crum & Forster

Underwriter, C&F Stop Loss

Phoenix, AZ · On-site +1

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... Send large claims reporting for nurse review * Develop strategic relationships with sales, brokers ...

Cfins

Underwriter, C&F Stop Loss

Phoenix, AZ · On-site

$60 - $80/hr

The C&F Stop Loss Underwriter is responsible for contributing to the development and management of ... nurse review * Develop strategic relationships with sales, brokers, third-party administrators ...

Cfins

$125 - $150/hr

The Director, Medical Underwriting role utilizes a high level of experience and advanced clinical expertise regarding nursing, insurance, medicine, stop loss insurance, reinsurance, claims, medical ...

Captive Resources

Clinical Risk Specialist RN

Itasca, IL · On-site

$137K - $150K/hr

The Clinical Risk Specialist RN is responsible for providing high quality case management and ... Reviewing stop-loss cases, making recommendations on potential cost of care, including lasers ...

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Stop Loss Nurse information

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$37

$56

$73

How much do stop loss nurse jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for stop loss nurse in the United States is $56.45, according to ZipRecruiter salary data. Most workers in this role earn between $48.80 and $63.46 per hour, depending on experience, location, and employer.

What is a stop loss nurse?

A Stop Loss Nurse is a registered nurse who works with insurance companies, third-party administrators, or employers to manage high-cost medical claims, often those that could exceed the stop loss insurance threshold. Their primary role is to review clinical information, coordinate care, and ensure that patients receive appropriate and cost-effective treatment. They also help identify potential risks and work to contain costs for catastrophic or complex medical cases. Stop Loss Nurses act as liaisons between healthcare providers, patients, and insurers to facilitate communication and optimize claim outcomes.

What are common challenges faced by stop loss nurses in their daily responsibilities?

Stop Loss Nurses often encounter challenges such as managing large caseloads, navigating complex insurance policies, and ensuring thorough documentation for high-cost claims. They must balance attention to detail with time-sensitive decision-making while collaborating closely with underwriters, case managers, and healthcare providers. Adaptability and strong communication skills are essential, as Stop Loss Nurses frequently need to clarify clinical information and advocate for appropriate coverage within tight deadlines.

What are the key skills and qualifications needed to thrive as a stop loss nurse?

To thrive as a Stop Loss Nurse, you need a strong background in clinical nursing, case management, and medical review, often with an active RN license and experience in insurance or managed care. Familiarity with utilization review software, claims management systems, and knowledge of stop loss insurance guidelines is crucial. Exceptional attention to detail, analytical thinking, and effective communication skills set top performers apart in this role. These skills ensure accurate risk assessment, effective collaboration with underwriters and providers, and optimal claim outcomes for the organization.

What is the difference between Stop Loss Nurse vs Case Manager Nurse?

AspectStop Loss NurseCase Manager Nurse
CredentialsRN license, possibly certifications in insurance or risk managementRN license, case management certification (CCM)
Work EnvironmentInsurance companies, third-party administrators, healthcare risk managementHospitals, insurance companies, healthcare organizations
Employer & Industry UsagePrimarily in insurance and risk management sectorsHealthcare settings, insurance, and managed care

The main difference between a Stop Loss Nurse and a Case Manager Nurse lies in their focus areas. Stop Loss Nurses specialize in managing insurance claims related to high-cost healthcare risks, ensuring proper coverage and risk mitigation. Case Manager Nurses coordinate patient care to optimize health outcomes and manage resources. While both roles require nursing credentials, their work environments and primary responsibilities differ, with Stop Loss Nurses focusing on insurance risk and Case Managers on patient care coordination.

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What states have the most Stop Loss Nurse jobs?

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Stop Loss Nurse jobs near you
Infographic showing various Stop Loss Nurse job openings in the United States as of September 2026, with employment types broken down into 4% As Needed, 57% Full Time, 16% Part Time, and 23% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $117,423 per year, or $56.5 per hour.

Stop Loss Underwriter Lead

Integrated Resources INC

Newark, NJ • On-site

Contractor

Medical, Life

Re-posted 21 days ago

Key responsibilities

  • Act as the business owner and P&L owner for the client's stop loss products, including designing and implementing business strategy, partnerships, operational approach, sales and marketing, pricing, and policies.

  • Build consensus and collaborate with leadership in Sales/Account Management, Actuarial, Underwriting, and Enrollment & Billing to ensure alignment and results.

  • Maintain, update, and enforce underwriting, actuarial, pricing, and marketing policies and procedures related to stop loss, and ensure regulatory compliance.

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Job Title: Stop Loss Underwriter Lead

Location: Newark NJ

Duration: 3 Months

This position will be the overall business owner for client's Stop Loss business. This will include Profit & Loss responsibility, business strategy, relationships, contracts, and results of any business partners, operational aspects, pricing and underwriting, relationship with actuarial support, and partnership with Sales/Account Management regarding marketing and sales strategy and results. This position will work cross functionally within client and with outside vendors and consultants to provide direction, ensure results, and build client's capability as a stop loss insurer.

Responsibilities:

  • Act as business owner, P&L owner, and thought leader in strategically and tactically designing and implementing client's stop loss products, business strategy, business partnerships, operational approach, sales & marketing approach and results, pricing and policies.
  • Build consensus with leadership of Sales/Account Management, Actuarial, Underwriting, and Enrollment & Billing.
  • Own relationships, contracts, and results of business partners.
  • Provide insight into the stop loss market from a competitive standpoint including but not limited to products offered and marketing.
  • Recommend initial approach and ongoing changes to stop loss position.
  • Include recommendations related to partners and tools (e.g., administrative and pricing).
  • Determine financial impact of recommended approaches to revenue generation efforts and P&L.
  • Maintain, update, enforce and test client's underwriting, actuarial, pricing, and marketing policies and procedures related to stop loss.
  • Train enterprise staff as necessary on stop loss and ongoing changes in policies and procedures.
  • Ensure regulatory compliance of stop loss products, contracts, and pricing.
  • Champion the needs of the Stop Loss business within the Enterprise, securing enterprise resource support and funding as necessary.
  • Medical stop-loss underwriting specifically needed. Other industry underwriting or stop-loss underwriting would not be applicable experience.


Qualifications

Education:

  • Four year college degree required.
  • Concentration in Finance or other business/analytical area a plus.
  • Prefer MBA.

Additional licensing, certifications, registrations:

  • None required. Prefer FSA/ASA.
  • Requires a minimum of 8 years stop loss industry experience.
  • Experience negotiating with external vendors required.
  • Experience leading for change is required.
  • Actuarial or underwriting expertise in stop loss required.
  • Consulting experience desired.

Competencies:

  • Requires creative thinking, strong leadership, communication, analytical and financial technical skills.
  • Must understand complex financial concepts.
  • Requires excellent interpersonal skills, the ability to interact cross functionally, build relationships, and drive change.
Additional Information

If you are not interested in looking at new opportunities at this time I fully understand. I would in that case be appreciative of any referrals you could provide from your network of friends and colleagues in the industry.

we do have referral bonus of $500 per candidate, if you refer any of your friends or colleague who are looking out for the same job.


Kind Regards

Dipti Ghodke

Senior Technical Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I

DIRECT # - 732 - 844 -8719

(W) # 732-549-2030 - Ext - 315

 www.irionline.com

LinkedIn: https://in.linkedin.com/in/diptighodke

Gold Seal JCAHO Certified for Health Care Staffing

"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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