ZipRecruiter

Log In

1

Stop Loss Rn Jobs in Atlanta, GA (NOW HIRING)

Swiss Re

Clinical Risk Manager

Alpharetta, GA · 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 ...

NurseCare Buckhead

Registered Nurse (RN)

Atlanta, GA · On-site

Registered Nurses (RN) for 7PM - 7AM (12-Hour) Shift. General Purpose: Provide direct nursing care ... Notify the attending physician of automatic stop orders prior to the last dosage being administered

NurseCare Buckhead

Registered Nurse (RN)

Atlanta, GA

Registered Nurses (RN) for 7PM - 7AM (12-Hour) Shift. General Purpose: Provide direct nursing care ... Notify the attending physician of automatic stop orders prior to the last dosage being administered.

NurseCare Buckhead

Registered Nurse (RN)

Atlanta, GA

Registered Nurses (RN) for 7PM - 7AM (12-Hour) Shift. General Purpose: Provide direct nursing care ... Notify the attending physician of automatic stop orders prior to the last dosage being administered.

NurseCare Buckhead

Registered Nurse (RN)

Atlanta, GA · On-site

Registered Nurses (RN) for 7PM - 7AM (12-Hour) Shift. General Purpose: Provide direct nursing care ... Notify the attending physician of automatic stop orders prior to the last dosage being administered

NurseCare Buckhead

Registered Nurse (RN)

Atlanta, GA · On-site

Registered Nurses (RN) for 7PM - 7AM (12-Hour) Shift. General Purpose: Provide direct nursing care ... Notify the attending physician of automatic stop orders prior to the last dosage being administered.

Pyramid Corporation

Registered Nurse

Atlanta, GA · On-site

$25 - $28/hr

Talented Registered Nurse Needed Immediate need for a talented registered nurse. This is a six ... You can reply STOP to cancel and HELP for help. You can access our privacy policy here.

Bestica

Travel Cardiac Tele RN

Stockbridge, GA · On-site

$1.7K - $2.3K/wk

Required -- hard stop if no prior travel experience * First-time travelers: Not accepted * Patient population: Adults to geriatrics * Typical patient ratio experience: 1:6 * Charting: Epic preferred

Pyramid Consulting

Registered Nurse

Atlanta, GA · On-site

$25 - $28/hr

Immediate need for a talented Registered Nurse This is a 06 months contract to Hire opportunity ... You can reply STOP to cancel and HELP for help. You can access our privacy policy here. #was1

next page

Showing results 1-20

All JobsStop Loss Rn JobsStop Loss Rn Jobs in Atlanta, GA

Stop Loss Rn information

See Atlanta, GA salary details

$65.4K

$110K

$198.1K

How much do stop loss rn jobs pay per year?

As of Aug 28, 2026, the average yearly pay for stop loss rn in Atlanta, GA is $109,989.00, according to ZipRecruiter salary data. Most workers in this role earn between $94,700.00 and $121,600.00 per year, depending on experience, location, and employer.

What is a Stop Loss RN?

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 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.

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 are the most commonly searched types of Stop Loss Rn jobs in Atlanta, GA?

The most popular types of Stop Loss Rn jobs in Atlanta, GA are:

What are popular job titles related to Stop Loss Rn jobs in Atlanta, GA?

For Stop Loss Rn jobs in Atlanta, GA, the most frequently searched job titles are:

What job categories do people searching Stop Loss Rn jobs in Atlanta, GA look for?

The top searched job categories for Stop Loss Rn jobs in Atlanta, GA are:

Stop Loss Rn jobs near you
Infographic showing various Stop Loss Rn job openings in Atlanta, GA as of August 2026, with employment types broken down into 50% Part Time, and 50% Contract. Highlights an 100% In-person job distribution, with an average salary of $109,989 per year, or $52.9 per hour.

Director of Clinical & Cost Containment, Employee Benefits

Atlanta, GA • On-site, Remote

HUB International Limited

8.0

Company rating: 8.0 out of 10

Based on 140 frontline employees who took The Breakroom Quiz

169th of 314 rated insurance

People enjoy working here

Good employer

Recommended by parents

Learn more about HUB International Limitedexternal

$76K - $104K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 28 days ago

Job description

Position Summary
The Director of Clinical & Cost Containment is a senior strategic role within Strategic Benefit Resources (SBR) responsible for leading the clinical consulting and cost containment program capabilities that differentiate SBR's self-funded solutions in the wholesale distribution market. This individual serves as the primary clinical subject matter expert across SBR's book of business, partnering with sales, distribution, and stop-loss consulting teams to evaluate, implement, and communicate clinical cost containment strategies that drive measurable financial outcomes for employer clients.
This role bridges clinical expertise and consultative sales support - working directly with broker/consultant partners, TPAs, stop-loss carriers, and employer plan sponsors to identify high-cost claim drivers, optimize vendor program selection, and develop clinical frameworks that reduce plan cost and improve member outcomes.
Why This Role Exists
As the self-funded benefits market grows increasingly complex - driven by specialty drug spend, catastrophic claim frequency, and heightened employer demand for transparency - SBR's distribution model requires dedicated clinical leadership to:
  • Evaluate and validate cost containment vendor solutions (Rx carve-outs, case management, utilization review, reference-based pricing, direct contracting) presented to clients
  • Provide clinical oversight and credibility in stop-loss consulting engagements
  • Identify coverage gap risks (e.g., Rx carved out of medical stop-loss) and proactively protect clients and SBR's risk profile
  • Position SBR as a value-added clinical advisory resource to differentiate from transactional wholesale competitors

Key Responsibilities
Clinical Cost Containment Strategy
  • Lead the development and ongoing refinement of SBR's clinical cost containment framework, aligning strategies with market trends and client needs
  • Evaluate, vet, and recommend cost containment vendors and programs (utilization management, case management, pharmacy benefit management, transplant networks, reference-based pricing, direct primary care, etc.)
  • Analyze claims data, clinical utilization trends, and high-cost claimant profiles to identify actionable savings opportunities
  • Monitor medical cost trends, specialty drug pipelines, and catastrophic claim drivers to proactively advise clients and sales teams

Stop-Loss Carrier Support / Claims Support
  • Review TPA trigger reports and claim referrals to surface impending high-cost diagnoses and recommend clinical risk mitigation actions
  • Identify and communicate coverage gap risks when Rx is carved out of stop-loss contracts or when benefit plan design creates clinical exposure
  • Serve as clinical liaison between SBR, stop-loss carriers, TPAs, and employer plan sponsors on complex claims and risk management issues

Consulting & Distribution Enablement
  • Support SBR's sales and consulting teams with clinical presentations, client-facing materials, and technical talking points for broker/consultant audiences
  • Conduct clinical reviews and plan analyses for prospective and existing employer clients, translating clinical findings into financial impact narratives
  • Develop educational resources, webinars, and market-facing content that position SBR's clinical expertise as a competitive differentiator
  • Partner with distribution leadership and brokers/consultants to align cost containment program recommendations with individual client risk profiles and plan designs

Vendor Management & Program Oversight
  • Build and maintain relationships with clinical cost containment vendors, including case management firms, utilization review organizations, PBMs, and specialty program providers
  • Evaluate vendor performance through KPI monitoring, outcome tracking, and savings validation
  • Negotiate program terms and coordinate seamless integration of clinical vendors within the SBR distribution ecosystem
  • Stay current on regulatory developments, ERISA compliance requirements, and clinical best practices affecting self-funded plan design

Internal Leadership & Collaboration
  • Partner with the Chief Strategy Officer, COO, and sales leadership to align clinical strategy with SBR's overall growth objectives
  • Provide clinical training and education to internal SBR teams, ensuring consultants can confidently represent cost containment solutions
  • Contribute to the development of SBR's strategic plan as it relates to clinical program expansion, new vendor partnerships, and market positioning

Qualifications
Required
  • Bachelor's degree in Nursing, Healthcare Administration, Health Sciences, or a related clinical field; RN license strongly preferred
  • 5+ years of experience in clinical cost containment, case management, utilization management, stop-loss, or self-funded health plan consulting
  • Deep knowledge of self-funded employer benefit plan design, stop-loss insurance structures, and the TPA/wholesale distribution market
  • Demonstrated understanding of medical coding (ICD-10, CPT), clinical guidelines, and claims adjudication processes
  • Experience working with or evaluating cost containment vendors including case management, PBMs, reference-based pricing, and specialty drug management programs
  • Strong analytical and data interpretation skills; ability to translate clinical findings into financial and strategic insights
  • Excellent communication, presentation, and relationship management skills with broker, consultant, and employer-level audiences

Preferred
  • Certification in Case Management (CCM), Certified Employee Benefit Specialist (CEBS), or equivalent professional credential
  • Experience with pharmacy carve-out structures and Rx cost containment programs in the self-funded context (e.g., PMPM guarantee models, closed formulary programs)
  • Familiarity with all types of self funded arrangements including captive insurance structures, level-funded plans, or consortium-based stop-loss arrangements
  • Prior experience in a wholesale benefits distribution, MGU, or TPA environment
  • Working knowledge of ERISA, HIPAA, ACA implications for self-funded plan sponsors

Core Competencies
  • Clinical Expertise & Credibility - Trusted subject matter authority on medical management and cost containment within the self-funded market
  • Strategic Thinking - Connects clinical insights to business outcomes and competitive positioning
  • Consultative Communication - Translates complex clinical concepts for non-clinical stakeholders including brokers, employers, and executives
  • Analytical Rigor - Data-driven approach to evaluating program performance and identifying savings opportunities
  • Relationship Building - Skilled at developing trusted partnerships with vendors, TPAs, carriers, and distribution partners
  • Market Awareness - Proactive in monitoring industry trends, emerging cost drivers, and regulatory changes

Compensation & Benefits
SBR offers a competitive compensation package commensurate with experience, including:
  • Base salary commensurate with experience
  • Performance-based incentive compensation
  • Comprehensive health, dental, and vision benefits
  • Retirement plan with employer contribution
  • Professional development and continuing education support
  • Hybrid/remote work flexibility

The expected salary range for this position is $130,000 to $150,000 and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health/dental/vision/life/disability insurance, FSA, HAS and 401(k) accounts, paid-time-off benefits such as vacation, sick, personal, floating holidays and company holidays. In addition, eligible annual bonuses, equity and commissions may be available for some positions.
#SPG
Department Business Operations
Required Experience: 5-7 years of relevant experience
Required Travel: Up to 25%
Required Education: Bachelor's degree (4-year degree)
HUB International Limited is an equal opportunity employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations.
E-Verify Program
We endeavor to make this website accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the recruiting team HUBRecruiting@hubinternational.com. This contact information is for accommodation requests only; do not use this contact information to inquire about the status of applications.

What HUB International employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply