Role Overview Assess medical risk, predict and assign medical cost of care for claims and underwriting purposes Key Responsibilities - Assess medical cost and clinical data utilizing multiple data sources and various software - Provide risk assessment and cost projections for underwriting and claims based on medical condition, treatment plan and drug costs - Stay up to date with the latest medical advancements and how they affect cost projections and recommendations - Strong medical knowledge including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA - Strong understanding of third-party administrators (TPAs) - Strong understanding of medical stop loss What You Bring - Required Registered Nurse (RN) designation - 5 Years Relevant and progressive clinical experience, preferably in an acute care or managed care/setting - Strong medical knowledge, including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA - Strong understanding of the operations of third-party administrators(TPAs) and managing general underwriters (MGUs) - Knowledge of Carrier and Reinsurer reporting and contractual requirements - Possess and have ability to apply broad knowledge of principles, practices, and procedures - Excellent written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy - Exceptional organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously - Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business conditions What We Offer - Competitive salary and comprehensive benefit package - Strong learning culture with ongoing development opportunities - Opportunities for growth and career advancement - Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment - Basic life and disability insurance - 401(k) plan with 6% company match - 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off - Paid parental leave - Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription - Student loan matching program - Employee discount program - An opportunity to do meaningful work and love what you do The pay range for this position is $71,000-$156,600 which includes geographic adjustments, where applicable. The pay range is the range THMCC, in good faith, believes is the range of compensation for this role at the time of this posting. The hired applicant will be offered pay within the entire range based on the candidate's geographic location, qualifications, work experience, education, and/or skill level. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of color, race, sex, national origin, sexual orientation, religion, age, veteran status, disability, pregnancy, citizenship status, genetic information, or any other basis protected by federal, state, or local pay equity laws.