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Work From Home Stop Loss Rn Jobs in Arizona (NOW HIRING)

IQVIA

Work from Home

Tucson, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

The Jernigan Agency

WORK FROM HOME

Phoenix, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Peoria, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Phoenix, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

IQVIA

Work from Home

Gilbert, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

IQVIA

Work from Home

Chandler, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

The Jernigan Agency

WORK FROM HOME

Sedona, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

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Work From Home Stop Loss Rn information

What is a Work From Home Stop Loss RN?

A Work From Home Stop Loss RN is a registered nurse who works remotely, typically for insurance companies or third-party administrators, to review medical claims associated with stop loss insurance policies. Their main responsibility is to assess the medical necessity and appropriateness of claims that exceed certain thresholds, helping employers and insurers manage high-cost healthcare claims. These nurses use their clinical expertise to analyze medical records, communicate with providers, and ensure that claims are processed accurately and efficiently. Working from home allows them to perform these tasks virtually, often using secure digital platforms.

What are the key skills and qualifications needed to thrive as a Work From Home Stop Loss RN?

To thrive as a Work From Home Stop Loss RN, you need a current RN license, strong clinical assessment skills, and experience in utilization review or case management. Familiarity with health insurance systems, stop loss claims processes, and electronic medical record (EMR) platforms is typically required. Excellent attention to detail, critical thinking, and effective written communication are crucial soft skills for remote collaboration and accurate documentation. These abilities ensure accurate claim evaluations, regulatory compliance, and efficient coordination with insurers and healthcare providers.

What are some common challenges faced by Work From Home Stop Loss RNs, and how can they be addressed?

Work From Home Stop Loss RNs often face challenges related to remote communication, maintaining up-to-date clinical knowledge, and managing a high volume of case reviews. Since collaboration is primarily virtual, it's important to develop strong written and verbal communication skills to effectively coordinate with physicians, case managers, and insurance teams. Staying current with clinical guidelines and leveraging digital tools for documentation and workflow management can help streamline responsibilities and ensure accurate decision-making. Building a structured daily routine and proactively seeking support from team leads or mentors can also help address feelings of isolation and ensure ongoing professional growth.

What is the difference between Work From Home Stop Loss Rn vs Work From Home Case Manager?

AspectWork From Home Stop Loss RnWork From Home Case Manager
CredentialsRN license, certifications in insurance or risk managementRN license, case management certification
Work EnvironmentHome-based, insurance and healthcare settingsHome-based, healthcare and insurance industries
Industry UsageInsurance companies, healthcare providersInsurance companies, healthcare organizations
Job FocusManaging stop loss insurance claims and riskCoordinating patient care and insurance processes

While both roles require RN licensure and healthcare knowledge, the Work From Home Stop Loss Rn focuses on managing insurance claims related to stop loss coverage, emphasizing risk assessment. In contrast, the Work From Home Case Manager concentrates on coordinating patient care and insurance processes. Both roles are home-based and serve the healthcare and insurance industries, but their primary responsibilities differ significantly.

What are popular job titles related to Work From Home Stop Loss Rn jobs in Arizona?

For Work From Home Stop Loss Rn jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Work From Home Stop Loss Rn jobs in Arizona look for?

The top searched job categories for Work From Home Stop Loss Rn jobs in Arizona are:

What cities in Arizona are hiring for Work From Home Stop Loss Rn jobs?

Cities in Arizona with the most Work From Home Stop Loss Rn job openings:

Work From Home Stop Loss Rn jobs near you

Senior Underwriter - Medical Stop Loss - Remote

Jencap

Phoenix, AZ • On-site, Remote

$97K - $115K/yr

Full-time

Medical, Retirement

Re-posted 12 days ago

Job description

About the Company:

Jencap A&H is a leading provider of innovative insurance solutions for self-funded employers and their partners. We are committed to delivering exceptional value, service, and expertise to our clients. As part of our ongoing growth, we are seeking a highly experienced Senior Underwriter specializing in stop loss insurance to join our dynamic team.

The Senior Underwriter - Medical Stop Loss is responsible for the evaluation, risk assessment, pricing, and underwriting of stop loss insurance for selffunded employer groups. The ideal candidate brings strong stop loss market expertise, sound analytical judgment, and the ability to develop trusted relationships with brokers, consultants, TPAs, and internal stakeholders.

This role is ideally suited for candidates located in the Phoenix, AZ area working remotely; however, highly qualified candidates located elsewhere in the U.S. will be considered for a fully remote arrangement.

Key Responsibilities:

  • Underwrite new and renewal stop loss business in accordance with underwriting guidelines, risk appetite, and profitability targets
  • Analyze complex selffunded employer group data, including claims experience, demographics, plan design, and funding structures
  • Partner closely with the Chief Underwriting Officer to develop customized underwriting and pricing solutions
  • Establish and maintain strong relationships with brokers, consultants, TPAs, and clients; participate in finalist presentations and renewal discussions as needed
  • Monitor portfolio performance and support profitable growth initiatives
  • Contribute to underwriting process improvements, product enhancements, and bestpractice initiatives

Qualifications:

  • Bachelor's degree in business, finance, actuarial science, or a related field required; advanced degree or professional designations (e.g., CEBS, FLMI, ASA) preferred
  • 5-10 years of experience underwriting stop loss insurance for selffunded employer groups
  • Strong knowledge of stop loss insurance products, market dynamics, and regulatory requirements
  • Proven ability to make sound risk decisions and contribute to profitable portfolio performance
  • Excellent analytical, quantitative, and problemsolving skills
  • Strong relationshipbuilding, negotiation, and communication abilities
  • Proficiency in underwriting systems, analytics tools, and Microsoft Office Suite
  • Ability to work independently while collaborating effectively in a fastpaced, growthoriented environment

The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. Discretionary incentive compensation may be awarded. Jencap also offers a range of benefits and programs, based on eligibility, which currently include but are not limited to; comprehensive health care coverage, a 401k plan, and tuition reimbursement.  Jencap is an emerging and rapidly growing leader in the industry and as such, we approach talent acquisition as an opportunity to identify the best talent. Therefore, the level of the role and compensation may vary depending upon the best available candidate. 

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