Medical Stop Loss Underwriting Practice Lead - Accident & Health Who we are: American International ... Experience as an RN Medical Case Manager is ideal * Collaborative and strategic mindset with ...
Medical Stop Loss Underwriting Practice Lead - Accident & Health Who we are: American International ... Experience as an RN Medical Case Manager is ideal * Collaborative and strategic mindset with ...
Clinical Risk Specialist RN
$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 ...
Clinical Risk Specialist RN
$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 ...
Clinical Risk Specialist RN
Itasca, IL · On-site
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 ...
Clinical Risk Specialist RN
Itasca, IL · On-site
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 ...
Clinical Risk Specialist RN
$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 ...
Clinical Risk Specialist RN
$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 ...
Clinical Risk Manager
Schaumburg, IL · Hybrid
$84K - $140K/yr
Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...
Clinical Risk Manager
Schaumburg, IL · Hybrid
$84K - $140K/yr
Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...
Registered Nurse RN
Virden, IL · On-site
$38 - $45/hr
) Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Sunrise Skilled Nursing ... Apply today or stop by to complete an application. Walk-ins Welcome! Sunrise Skilled Nursing ...
Registered Nurse RN
Virden, IL · On-site
$38 - $45/hr
) Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Sunrise Skilled Nursing ... Apply today or stop by to complete an application. Walk-ins Welcome! Sunrise Skilled Nursing ...
Registered Nurse RN
$38 - $45/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Sunrise Skilled Nursing ... Apply today or stop by to complete an application. Walk-ins Welcome! Sunrise Skilled Nursing ...
Quick apply
Registered Nurse RN
$38 - $45/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Sunrise Skilled Nursing ... Apply today or stop by to complete an application. Walk-ins Welcome! Sunrise Skilled Nursing ...
Registered Nurse RN
$38 - $45/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
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Registered Nurse RN
$38 - $45/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
Registered Nurse RN
Taylorville, IL · On-site
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
Registered Nurse RN
Taylorville, IL · On-site
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
Registered Nurse RN
Taylorville, IL · On-site
$38 - $45/hr
) Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
Registered Nurse RN
Taylorville, IL · On-site
$38 - $45/hr
) Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Taylorville Skilled Nursing ... Apply online or stop by anytime for a walk-in application. Taylorville Skilled Nursing & Rehab 800 ...
Registered Nurse (RN)
Rockford, IL · On-site
$2.3K/wk
Registered Nurse (RN) Profession: Nursing Specialty: Registered Nurse Duration: 13 weeks Shift ... Email or text HELP for more info, or STOP to unsubscribe. Your mobile info will not be shared with ...
New
Registered Nurse (RN)
Rockford, IL · On-site
$2.3K/wk
Registered Nurse (RN) Profession: Nursing Specialty: Registered Nurse Duration: 13 weeks Shift ... Email or text HELP for more info, or STOP to unsubscribe. Your mobile info will not be shared with ...
New
Registered Nurse RN
$38 - $47/hr
Advance Your Nursing Career with us as a Registered Nurse (RN)! Location: Mount Zion Health ... Apply online today or stop by to complete an application in person. Mount Zion Health & Rehab 1225 ...
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Registered Nurse RN
$38 - $47/hr
Advance Your Nursing Career with us as a Registered Nurse (RN)! Location: Mount Zion Health ... Apply online today or stop by to complete an application in person. Mount Zion Health & Rehab 1225 ...
Registered Nurse RN
$40 - $50/hr
Advance Your Nursing Career with Us as a Registered Nurse (RN)! Location: Gillespie Health ... Apply online or stop by anytime for a walk-in application. Gillespie Health & Rehab 7588 Staunton ...
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Registered Nurse RN
$40 - $50/hr
Advance Your Nursing Career with Us as a Registered Nurse (RN)! Location: Gillespie Health ... Apply online or stop by anytime for a walk-in application. Gillespie Health & Rehab 7588 Staunton ...
Registered Nurse RN
Litchfield, IL · On-site
$40 - $47/hr
Join Our Team as a Registered Nurse (RN) - Full-Time Day Shift Location: Litchfield Health & Rehab ... Apply online today or stop by to complete an application in person. Litchfield Health & Rehab ...
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Registered Nurse RN
Litchfield, IL · On-site
$40 - $47/hr
Join Our Team as a Registered Nurse (RN) - Full-Time Day Shift Location: Litchfield Health & Rehab ... Apply online today or stop by to complete an application in person. Litchfield Health & Rehab ...
Registered Nurse RN
Carlinville, IL · On-site
$40 - $46/hr
Advance Your Nursing Career with Us as a Registered Nurse (RN) Location: Lakeside Health & Rehab - ... Apply online today or stop by to complete an application in person. Lakeside Health & Rehab 1200 ...
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Registered Nurse RN
Carlinville, IL · On-site
$40 - $46/hr
Advance Your Nursing Career with Us as a Registered Nurse (RN) Location: Lakeside Health & Rehab - ... Apply online today or stop by to complete an application in person. Lakeside Health & Rehab 1200 ...
Registered Nurse RN
$30 - $47/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Pana Health & Rehab Center ... Apply today or stop by to fill out an application. Pana Health & Rehab Center 1000 E 6th St Pana ...
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Registered Nurse RN
$30 - $47/hr
Start Your Nursing Career with Us as a Registered Nurse (RN)! Location: Pana Health & Rehab Center ... Apply today or stop by to fill out an application. Pana Health & Rehab Center 1000 E 6th St Pana ...
Registered Nurse RN
$38 - $48/hr
Exciting RN Opportunity at Beardstown Health & Rehab! Location: Beardstown Health & Rehab - ... Apply online or stop by anytime for a walk-in application. Beardstown Health & Rehab 8306 St. Lukes ...
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Registered Nurse RN
$38 - $48/hr
Exciting RN Opportunity at Beardstown Health & Rehab! Location: Beardstown Health & Rehab - ... Apply online or stop by anytime for a walk-in application. Beardstown Health & Rehab 8306 St. Lukes ...
RN - RN
Rockford, IL · On-site
$2.1K/wk
Details Client Name Mosaic - Rockford, IL Job Type Travel Offering Nursing Profession RN Specialty ... reply STOP to cancel and HELP for help) Client Details Address 1111 S Alpine Rd Ste 401 City ...
New
RN - RN
Rockford, IL · On-site
$2.1K/wk
Details Client Name Mosaic - Rockford, IL Job Type Travel Offering Nursing Profession RN Specialty ... reply STOP to cancel and HELP for help) Client Details Address 1111 S Alpine Rd Ste 401 City ...
New
Registered Nurse RN
$42 - $50/hr
Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...
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Registered Nurse RN
$42 - $50/hr
Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...
Registered Nurse RN
Pekin, IL · On-site
$42 - $50/hr
) Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...
Registered Nurse RN
Pekin, IL · On-site
$42 - $50/hr
) Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...
Stop Loss Rn information
How to make $200,000 as a nurse?
What are the typical daily responsibilities of a Stop Loss RN?
As a Stop Loss RN, your typical day involves reviewing high-cost medical claims, verifying the medical necessity of treatments, and assessing policy compliance to determine insurance coverage. You’ll collaborate closely with clinical staff, insurance specialists, and sometimes directly with healthcare providers to gather relevant information and ensure accurate case evaluations. Many Stop Loss RNs also prepare detailed reports and participate in case conferences. This role often combines remote desk work with communications across multidisciplinary teams, creating a dynamic environment well-suited for nurses looking to leverage their clinical expertise in an insurance or administrative setting.
How to make an extra $2000 a month as a nurse?
What jobs pay 4000 a week without a degree?
What are the key skills and qualifications needed to thrive in the Stop Loss Rn position, and why are they important?
To thrive as a Stop Loss RN, you need in-depth clinical nursing experience, a strong understanding of insurance policies and claims, and RN licensure. Familiarity with medical claims adjudication systems, electronic health records, and utilization review platforms is typically required. Excellent communication, critical thinking, and attention to detail set top performers apart in this role. These skills are important to effectively review complex medical cases, ensure appropriate healthcare coverage, and collaborate with both providers and insurers.
What is a Stop Loss RN job?
A Stop Loss RN is a registered nurse who reviews medical claims and patient records to evaluate the necessity, accuracy, and cost of healthcare services for insurance companies or employers. They help determine whether claims exceed stop-loss insurance thresholds, which protect insurers or self-funded employers from excessive financial risk. This role involves assessing medical necessity, verifying coding accuracy, and collaborating with case managers, providers, and insurance teams. Strong analytical skills and clinical expertise are essential for making informed decisions on high-cost claims.
What does a stop loss nurse do?
$118K - $178K/yr
Full-time
Posted 17 days ago
AIG rating
8.4
Based on 22 frontline employees who took The Breakroom Quiz
113th of 298 rated insurance
Job description
Medical Stop Loss Underwriting Practice Lead - Accident & Health
Who we are:
American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security.
Get to know the business:
AIG underwriting teams help to find insurance solutions in areas including Financial Lines, Property, Casualty, Specialty Lines, Cyber, Multinational Clients, and High Net Worth individuals. We are reimagining how we help customers to manage risk, transforming our operating model, and reshaping our role responsibilities and career pathways. The goal is to unlock the full potential in each colleague - empowering our people to grow as insurance professionals and add more value to our customers and AIG.
The Medical Stop Loss Underwriting Practice Lead is responsible for evaluating, pricing, and managing risk on employer group stop-loss business. This role requires advanced technical expertise in underwriting Specific and Aggregate Stop Loss plans for self-funded medical plans and a strong understanding of risk factors, industry trends, and broker/client expectations.
How you will create an impact:
Financial / Business Development
- Responsible for achievement of top and bottom-line results for new and renewal business.
- Deliver on underwriting profit results with focus on profitability, loss ratio and combined ratio.
- Develop, maintain and grow relationships with external business partners to drive healthy organic growth of business.
- Collaborate and cross-sell with other internal stakeholders and lines of business within AIG.
Key Responsibilities
- Management and Oversight of Program Managers with Delegated Underwriting Authority
- Creation of Underwriting Guidelines and oversight / audit of adherence to those guidelines
- Timely handling of Case referrals
- Develop and maintain alignment of partnership expectations.
- Analyze group medical claims data, demographics, and plan designs to assess risk and determine appropriate stop-loss premiums and terms.
- Collaborate with distribution and actuarial teams on complex case evaluations, renewals, and new business opportunities.
- Develop and maintain strong relationships with brokers, consultants, and third-party administrators (TPAs).
- Present underwriting rationale and recommendations to internal stakeholders with clarity and confidence.
- Ensure compliance with underwriting guidelines, regulatory requirements, and company risk tolerance.
- Recommend modifications to underwriting practices and tools based on emerging market trends and experience.
- Mentor and train junior underwriters, sharing technical expertise and best practices.
- Support development of new products, pricing strategies, and process improvements to enhance competitiveness.
What you will need to succeed
- Bachelor's degree or higher and / or equivalent experience.
- Minimum 7+ years of medical stop-loss underwriting experience; strong background in both specific and aggregate coverage.
- Knowledge and understanding of healthcare payers, health plan administration, and medical service providers.
- Advanced Knowledge of Medical Underwriting practices and principles.
- Excellent analytical, mathematical, and communication skills.
- Ability to manage multiple priorities and make sound underwriting decisions in a fast-paced environment.
- Demonstrated ability to build broker and TPA relationships and support business growth initiatives.
- Demonstrated ability to develop and execute strategies to grow profitability and production growth.
- Strong customer service ethic, with a sound understanding of the business processes.
- Self-motivated and able to set strategic direction.
- Able to work in a team to lead and contribute so that AIG meets its strategic goals.
- Knowledge of state regulatory and compliance requirements.
- Ability to multi-task and handle divisional objectives as requested and handles multiple priorities often under tight deadlines.
- Strong sense of responsibility for one's actions and work.
Preferred Attributes
- Strong knowledge of ERISA plans, self-funding structures, and cost containment programs.
- A cost containment background, such as utilization review or managed care is helpful
- Experience as an RN Medical Case Manager is ideal
- Collaborative and strategic mindset with attention to detail and accuracy
For positions based in NYC, NY, the base salary range for this position is $118,000-$178,000, for positions based in New Jersey, the base salary range for this position is $126,000-$171,000, for positions based in Illinois the base salary range for this position is $125,000-$173,000, and the positionis eligible for a bonus in accordance with the terms of theapplicable incentive plan. In addition,we're proud to offer a range ofcompetitive benefits, a summary of whichcan be viewed here: US Benefits Overview
At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.
Enjoy benefits that take care of what matters
At AIG, our people are our greatest asset. We know how important it is to protect and invest in what's most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security-as well as your professional development-to bring peace of mind to you and your family.
Reimagining insurance to make a bigger difference to the world
American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching property casualty networks. It is an exciting time to join us - across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.
Welcome to a culture of inclusion
We're committed to creating a culture that truly respects and celebrates each other's talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG's greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.
AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.
AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to candidatecare@aig.com.
AIG reserves the right to conduct a criminal background check, tailored to the requirements of a job, after a conditional employment offer is made. Unless otherwise required by law, AIG does not automatically exclude any applicant with a criminal conviction for a job or class or jobs. For more information about Philadelphia law specifically, copy and paste the following link within your browser: http://www.phila.gov/HumanRelations/PDF/BTB%20POSTER%20FINAL_3-9-16.pdfFunctional Area:
About AIG
Sourced by ZipRecruiter
American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security.
Industry
Insurance services
Company size
10,000+ Employees
Headquarters location
New York, NY, US
Year founded
1919