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Work From Home Stop Loss Rn Jobs in Newark, NJ (NOW HIRING)

WORK FROM HOME

Hoboken, NJ · 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

See Newark, NJ salary details

$71.1K

$119.6K

$215.4K

How much do work from home stop loss rn jobs pay per year?

As of Sep 1, 2026, the average yearly pay for work from home stop loss rn in Newark, NJ is $119,604.00, according to ZipRecruiter salary data. Most workers in this role earn between $103,000.00 and $132,300.00 per year, depending on experience, location, and employer.

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 Newark, NJ?

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

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

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

What cities near Newark, NJ are hiring for Work From Home Stop Loss Rn jobs?

Cities near Newark, NJ with the most Work From Home Stop Loss Rn job openings:

Infographic showing various Work From Home Stop Loss Rn job openings in Newark, NJ as of August 2026, with employment types broken down into 64% Full Time, 26% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $119,604 per year, or $57.5 per hour.

Actuarial Analyst II (Stop Loss)

Horizon Blue Cross Blue Shield of New Jersey

Newark, NJ • On-site, Remote

$79K - $105K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 12 days ago


Horizon Blue Cross Blue Shield of New Jersey rating

8.3

Company rating: 8.3 out of 10

Based on 23 frontline employees who took The Breakroom Quiz

132nd of 315 rated insurance


Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

About the Role

This is the mid-level analyst position within Actuarial department. Includes all aspects of actuarial work, as related to Stop Loss and Level Funded groups. Responsible for pricing, UW support, reserving and forecasting for both Specific and Aggregate Stop Loss, as well as Level Funding.

What You'll Do

  • Design, perform or support trend analysis

  • Perform pricing, UW support, reserving and forecasting for both Specific and Aggregate Stop Loss, as well as Level Funding.

  • Perform or support forecasting

  • Support new business and renewal pricing decisions, including underwriting consultation and risk assessment.

  • Develop or support the development of pricing models and support pricing requests which may include, benefit adjustment factors, fee schedule analysis, new product pricing, etc.

  • Collect and analyze data to use for financial and utilization analysis, reporting, and monitoring (including IBNR)

  • Partner with internal and external customers to develop creative solutions and strategies, uncover opportunities and minimize risks

  • Support corporate strategies and business plan development for membership growth & financial strength

  • Lead meetings with business partners providing transparency in and an understanding of the actuarial analyses and results

What You Bring

Education/Experience:

  • Requires a Bachelor's degree, preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university.

  • Requires 2+ years of Actuarial and/or statistics experience.

  • Working towards an ASA highly preferred.

  • Experience with Level Funded products, medical Stop Loss or Reinsurance products preferred.

Knowledge:

  • Excellent knowledge of features of Stop Loss product, from both Actuarial and UW perspective.

  • Knowledge of the Reinsurance industry

  • Requires expert knowledge of Excel.

  • Experience with SQL, SAS, Tableau, Power BI, or other analytical/reporting tools preferred.

  • Requires strong working knowledge of data analysis and Actuarial principles.

  • Requires in depth knowledge of the healthcare industry.

Skills & Abilities:

  • Requires excellent oral and written communication skills.

  • Requires strong analytical thinking.

  • Requires strong mathematical skill and statistical analysis abilities.

  • Requires good judgment and problem-solving skills.

Why Horizon?

At Horizon, you'll do meaningful work that directly improves lives-while being supported by a missiondriven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!

Salary Range:

$79,100 - $105,945

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

  • Comprehensive health benefits (Medical/Dental/Vision)

  • Retirement Plans

  • Generous PTO

  • Incentive Plans

  • Wellness Programs

  • Paid Volunteer Time Off

  • Tuition Reimbursement

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.


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