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Work From Home Stop Loss Rn Jobs (NOW HIRING)

Projects come from all areas of the industry, but we do place an emphasis on the Insurance ... This work covers both the P&C and L&H sides of the business. To review all of our insurance job ...

Kulpsville, PA We offer hybrid work schedule with 4 days in the office; and 1 day remote where it ... from external recruiting firms. The company offers a competitive compensation plan and robust ...

The typical work hours are Monday - Friday from 8:30am - 5pm EST. Sponsorship : This position is ... Design stop loss coverage and introduce services to best meet needs of client. Emphasize client ...

Kulpsville, PA We offer hybrid work schedule with 4 days in the office; and 1 day remote where it ... from external recruiting firms. The company offers a competitive compensation plan and robust ...

New

Senior Underwriter - Medical Stop Loss

Danvers, MA · On-site +1

$104K - $123K/yr

Our teams are empowered and work together to find solutions. We have a passion culture - with ... The Senior Underwriter - Medical Stop Loss is responsible for the evaluation, risk assessment ...

Examiner - Stop Loss

$24.62 - $41.04/hr

Our programs are built to make your life better both at work and at home. * Flexible full-time or ... Disqualification from the recruitment process * Withdrawal of a job offer * Termination of ...

Examiner - Stop Loss

Bellevue, WA · On-site +1

$24.62 - $41.04/hr

Our programs are built to make your life better both at work and at home. * Flexible full-time or ... Disqualification from the recruitment process * Withdrawal of a job offer * Termination of ...

Stop Loss & Health Claim Analyst

OR · On-site +1

$54K - $81K/yr

Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in ... individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we ...

Stop Loss & Health Claim Analyst

OR · On-site +1

$54K - $81K/yr

Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in ... individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we ...

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Work From Home Stop Loss Rn information

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$68K

$114.4K

$206K

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

As of Jun 7, 2026, the average yearly pay for work from home stop loss rn in the United States is $114,374.00, according to ZipRecruiter salary data. Most workers in this role earn between $98,500.00 and $126,500.00 per year, depending on experience, location, and employer.

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 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 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 are the key skills and qualifications needed to thrive as a Work From Home Stop Loss RN, and why are they important?

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.
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Director, Stop Loss Market Relations

Crumdale Specialty

Paoli, PA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 11 days ago


Job description

About Crumdale Specialty:

Crumdale Specialty is a diversified insurance firm providing custom solutions to businesses nationwide. We leverage industry expertise, superior talent, and a disruptive mindset to provide agile, transparent, and cost-saving solutions to optimize self-funded health plans. Founded in 2014, we are the fastest-growing purveyor of integrated insurance solutions, with deep-rooted experience in program management, TPA administration, PBM consulting, stop-loss coverage, compliance, risk management, underwriting, and analytics.

At Crumdale, people come first. Our clients, colleagues, trading partners, and communities are our strength. Our company culture is rooted in alignment, innovation, and integrity. We are proud to be named an Inc. Magazine Best Places to Work in multiple years.

Reporting to the SVP of Stop Loss & Sales Operations, the Director of External Market Stop Loss Relations will act as Crumdale’s external market stop loss relationship subject matter expert responsible for developing new, and enhancing existing, relationships with external stop loss carrier partners. Working collaboratively and in the interest of Crumdale, drive detail, discipline, and accountability with external stop loss carriers with respect to communication, expectations, timelines, and results. The successful Director will increase the number of stop loss carrier partners and the number of competitive stop loss quotes produced by Crumdale through Crumdale’s Stop Loss Center of Excellence but is not accountable for the sale.

The Director of External Market Stop Loss Relations will provide ongoing stop loss expertise to internal and external stakeholders to include working across various functional areas. This role will work on both tactical and strategic aspects of stop loss quoting and pricing for new business and renewals, working closely with Regional Sales Directors and Sales VPs. This role will also drive forward the orchestration and execution of stop loss related initiatives on behalf of the SVP of Stop Loss & Sales Operations, thereby extending the effectiveness of the organization. 

Duties & Responsibilities:

  • Develop strong stop loss carrier partnerships with Crumdale’s existing stop loss partners as well as identify and cultivate new stop loss carrier partnerships. 
  • Implement new, and enhance existing, processes to improve efficiency and speed to quote while driving competitive performance from Crumdale’s stop loss partners.
  • Mastery of Crumdale’s cost containment programs, how they impact plan pricing and their application to stop loss insurance. 
  • Work closely with the Pricing, Quoting, & Center of Excellence teams to develop proper quote requests and process to maximize impact to the organization. 
  • Negotiate proposals with and without direction to secure the best possible quotes prior to releasing to the sales team. 
  • Help the team drive more stop loss proposals to go firm and final and ultimately close as new sold business.
  • Leverage technology and artificial intelligence to amplify the expertise of the team and Crumdale’s carrier partners, and accelerate quote throughput thus reducing time to quote at all stages of the process.

Requirements

Qualifications & Skills:

  • Self-funded employee benefits industry experience with minimum 5 years’ experience in stop loss / medical reinsurance sales (10+ years’ preferred)
  • Extensive knowledge of, and relationships in, medical stop loss underwriting
  • Captive experience, preferred
  • Excellent communication, interpersonal, and organizational skills
  • Superior critical thinking and analytic skills
  • Ability to form strong relationships with internal and external teammates
  • Proven ability to lead and develop a high performing team
  • Ability to maintain a high level of confidentiality

Education:

  • Bachelor’s degree in business, finance, and / or similar discipline with analytic basis*
  • Experience with Salesforce, preferred
  • Proficient with MS Office suite

*Equivalent military service at E4 or higher is acceptable in place of a bachelor’s degree

Travel Requirement:

  • Ability to travel overnight up to 20%, required

Benefits

At Crumdale, we strive to provide a comprehensive and supportive benefits package to ensure the well-being of our employees. Our benefits include:

  • Medical
  • Telemedicine
  • Dental
  • Vision
  • Life, AD&D, Disability
  • 401(k)
  • Flexible Time-off

Please note: Crumdale Specialty is not engaging with external recruitment agencies; please refrain from contacting us regarding this position.