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

WORK FROM HOME

Fresno, CA · 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 ...

WORK FROM HOME

Riverside, CA · 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 ...

New

WORK FROM HOME

Anaheim, CA · 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 ...

WORK FROM HOME

Santa Ana, CA · 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 cities in California are hiring for Work From Home Stop Loss Rn jobs?

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

Infographic showing various Work From Home Stop Loss Rn job openings in California as of August 2026, with employment types broken down into 72% Full Time, 18% Part Time, and 10% Contract. Highlights an 100% Remote job distribution.

Regional Account Manager Medical Stop Loss

Prudential

Walnut Creek, CA • On-site, Remote

$82K - $136K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago


Prudential rating

8.7

Company rating: 8.7 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

70th of 311 rated insurance


Job description

Job Classification:

Sales - Sales

Group Insurance is an operating unit within the U.S. Businesses Division that primarily focuses on creating, distributing, and administering a complex range of life and disability insurance products for many top Fortune 500 companies. Prudential's Group Insurance (GI) Distribution organization delivers benefit services and solutions needed to fulfill our purpose of making lives better by solving the financial challenges of our changing world. The group is comprised of early talent, experienced, and executive teams with a keen focus on customer and marketplace centricity.

Prudential's Group Insurance (GI) is seeking a Regional Account Manager for the Medical Stop Loss Distribution team to provide sales-cycle and administrative support to assigned to one or multiple Regional Sales Directors, MSL. The Regional Account Managers are required to command a comprehensive knowledge of the MSL prospect and customer base, RFP pipeline, producer relationships, key contacts, products offered, and must develop a proficiency with relevant Prudential systems and software. The Regional Account Manager will be a key member of the regional MSL Distribution team working closely with the Regional Sales Director, MSL.

Responsibilities: Support and manage the RFP pipeline for the Medical Stop Loss business for both new sales and renewal opportunities, collecting the necessary data required to develop a comprehensive proposal in a timely manner. Provide administrative sales support and serve as a liaison for sales personnel, customers, producers, and home office contacts. Partner with the GI Sales Executives, Account Executives, or Account Managers to manage Request for Proposal (RFP) process including monitoring of RFP inboxes, entering data into internal sales systems, ensuring internal partners adhere to RFP timeline, review responses for completion and distribute proposal responses, and interfacing with brokers on behalf of the Regional Sales Director, MSL and GI sales team. Office management activities including organizing and upkeep of the office, as well as other office duties which include ensuring shared office equipment and supplies are available and in working order. Serve as a resource for new hires and assist with new hire on-boarding for MSL distribution team. Participate in team meetings/trainings and serve as a backup for other team members when required. Document and maintain relevant sales and customer record systems to meet compliance requirements. Support customer activities including finalist meetings, enrollment, and benefit fair preparation; ordering brochures and giveaways. Work on special projects throughout the year.

Business Development: Coordinating Marketing, Sales, and Support service for assigned accounts. Possessing an understanding of your assigned customers' requirements and initiating actions that maintain high levels of customer satisfaction. Proactively partnering with internal contacts to facilitate timely resolution of issues or problems presented by customers and/or brokers. Presenting products, services, and plan design information to meet customer needs. Addressing customer questions and concerns regarding any aspect of our product offering.

Qualifications: 2-3 years of Stop Loss product and/or account management experience Strong customer service experience and managing deadlines. Medical Stop Loss industry, sales administration, broker relations, customer service, RFP pipeline management or equivalent experience. Knowledge and understanding of customer service and relationship management concepts preferred. A detail-orientated individual with strong analytic, organization and time management skills Excellent communication and presentation skills. Must be customer focused and resolution oriented. Ability to manage multiple priorities in a timely manner. Demonstrated success in servicing multiple small to medium financial/insurance accounts. Three (3) plus years of relevant experience. Self-motivated with the ability to work independently and provide timely results. The ability to develop and grow relationships, while maintaining targeted retention rates. Proven ability to successfully partner with consultants, brokerage firms and/or third-party administrators. Excellent written/verbal communication and presentation skills. Strong organization and time management skills. Solid knowledge of group insurance products and services preferred. Active Life and Health Insurance license or obtained within 30 days of hire.

What we offer you:
Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $82,500.00 to $136,100.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.
  • Market competitive base salaries, with a yearly bonus potential at every level.
  • Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave.
  • 401(k) plan with company match (up to 4%).
  • Company-funded pension plan.
  • Wellness Programs including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs.
  • Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.
  • Education Benefit to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs.
  • Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period).

Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.


Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.


Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.


If you need an accommodation to complete the application process, please email accommodations.hw@prudential.com.

If you are experiencing a technical issue with your application or an assessment, please email careers.technicalsupport@prudential.com to request assistance.


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