Top 21 Medical underwriter rn Jobs

Clinical Risk Nurse
TPAC Underwriters —Blaine, MN
- $90,000 - $120,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
11d
Lead Medical Coordinator ORR (Bilingual Spanish RN)
HEARTSHARE HUMAN SERVICES OF NEW YORK —Brooklyn, NY
- $130,000 - $135,000 a year
- Email
- Spanish
- Nursing
- Anatomy knowledge
- Health insurance
- Dental insurance
Quick Apply
Senior Director, Telehealth Operations
Banner Health —Phoenix, AZ
- Full-time
- CPA
- Senior level
- Leadership
Temporary Underwriter
illumifin —Eden Prairie, MN
- From $25 an hour
- Temporary
- Bachelor of Science
- Mid-level
- Bachelor's degree
Medical Coordinator
Bethany Christian Services USA LLC —Paw Paw, MI
- On call
- Spanish
- Nursing
- Current TB test
- Wellness program
- 403(b) matching
Clinical Risk Manager, Schaumburg (IL, US), Alpharetta (GA, US) and Windsor (CT, US).
Swiss Re —Schaumburg, IL
- $84,000 - $140,000 a year
- Hybrid work
- Nursing
- Microsoft Excel
- RN License
Lead Medical Coordinator
Bethany Christian Services USA LLC —Charlotte, NC
- On call
- Spanish
- Nursing
- Current TB test
- Wellness program
- 403(b) matching
Medical Director, DI Underwriting Governance
MassMutual —Boston, MA
- $209,700 - $275,100 a year
- Medicine
- RN License
- Analysis skills
- Commuter assistance
- Paid holidays
14d
Senior Director, Ambulatory Services
Banner University Medical Group —Phoenix, AZ
- Full-time
- Medicine
- CPA
- Clinic
13d
Care Team Nurse - RN
Peak Vista Community Health Centers —Colorado Springs, CO
- $32.39 - $46.96 an hour
- Full-time
- Spanish
- CPR Certification
- Nursing
- 403(b) matching
- Disability insurance
Quick Apply
Medical Stop Loss Underwriting Practice Lead, Accident & Health
National Union Fire Insurance Company of Pittsburgh, Pa. —Philadelphia, PA
- $118,000 - $178,000 a year
- Email
- 7 years
- Customer service
- Office
- Health insurance
Quick Apply
System Director of Risk Management
UofL Health —Louisville, KY
- Full-time
- Microsoft Excel
- Microsoft Outlook
- RN License
Bilingual Medical Coordinator
Bethany Christian Services USA LLC —Reading, PA
- On call
- Spanish
- Nursing
- Current TB test
- Wellness program
- 403(b) matching
Lead Medical Coordinator - Bilingual (English/Spanish)
Bethany Christian Services USA LLC —Indianapolis, IN
- On call
- Spanish
- Nursing
- Current TB test
- Wellness program
- 403(b) matching

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Unum Group —Portland, ME
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Clinical Risk Nurse

TPAC Underwriters -
Blaine, MN

Apply Now

Job Details

Full-time
$90,000 - $120,000 a year
11 days ago

Qualifications

Microsoft Excel
Microsoft Outlook
RN License
HCPCS
Health insurance knowledge
Medical treatment knowledge
Medical terminology
Analytics

Full Job Description

Description:

A CAREER AT TPAC

Working at TPAC, you’ll experience a culture that is made up of a group of people who are supportive, innovative, collaborative, and caring towards each other and the customers we serve. TPAC is looking for a Clinical Risk Nurse to join our team. This is a remote or hybrid, full-time position located in our Blaine, MN office depending on location. Join our team and help us change the way healthcare is financed, disclosed and delivered.

OUR VISION FOR THIS KEY ROLE

The Clinical Risk Nurse provides clinical expertise to support TPAC's underwriting and claims operations by evaluating medical risk, analyzing complex clinical data, and identifying cost drivers within the medical stop-loss portfolio. This role serves as the bridge between clinical knowledge and financial risk assessment — reviewing large claims, medical records, treatment plans, and diagnoses to inform underwriting decisions, pricing, and reserving. The Clinical Risk Nurse collaborates closely with underwriters, claims analysts, and leadership to ensure that TPAC's risk evaluation is grounded in clinical accuracy, supporting the company's mission of bringing transparency and innovation to healthcare financing.

Salary Range: $90,000 - $120,000

A SAMPLE OF WHAT YOU’LL GET TO DO IN THIS JOB

Review and evaluate medical records, clinical documentation, treatment plans, and diagnoses to assess risk severity, prognosis, and potential claim exposure for new business and renewal cases
Provide clinical insights and recommendations to underwriters on complex or high-exposure cases involving catastrophic, chronic, or specialty conditions
Analyze large claims and high-cost claimants, identifying trends in treatment, utilization, and cost drivers across the stop-loss portfolio
Conduct medical risk assessments including evaluation of transplant cases, oncology protocols, neonatal care, specialty pharmaceuticals, and other high-cost conditions
Develop and maintain clinical risk scoring models and reference tools to support consistent and accurate underwriting evaluations
Monitor emerging medical trends, new treatment protocols, pharmaceutical developments, and regulatory changes that may impact claims costs and stop-loss pricing
Collaborate with the Claims Department to review ongoing large claims, validate clinical appropriateness, and support reserving accuracy
Assist with the identification and evaluation of potential cost containment strategies including case management referrals, centers of excellence, and utilization review opportunities
Serve as a clinical subject matter expert for internal training, educating underwriting and claims staff on medical terminology, diagnoses, treatment pathways, and cost implications
Prepare clinical summaries and risk reports for underwriting leadership, reinsurers, and client presentations
Participate in TPA reviews and audits, evaluating the clinical accuracy and appropriateness of claims handling
Support special projects and ad hoc clinical analyses as directed by leadership
Partner with Third-Party Administrators (TPAs), brokers, and other stakeholders to proactively manage large and complex claims, identify risk mitigation strategies, and develop effective cost-containment solutions
Track, analyze, and report identified and realized claim savings, providing insights and recommendations to support organizational risk management and financial objectives

Requirements:

WHAT YOU’LL BRING TO THE JOB

Active Registered Nurse (RN) license required; Bachelor of Science in Nursing (BSN) preferred
7+ years of clinical nursing experience, with a strong background in critical care, case management, utilization review, or risk management
3+ years of experience in a stop-loss, reinsurance, health insurance, or managed care environment preferred
Strong knowledge of medical terminology, disease processes, treatment protocols, and pharmaceutical therapies
Familiarity with ICD-10, CPT, HCPCS coding systems and their application to claims and underwriting
Understanding of self-funded health plans, stop-loss insurance, and reinsurance structures
Excellent analytical skills with the ability to translate complex clinical information into financial risk assessments
Strong written and verbal communication skills with the ability to present clinical findings to non-clinical audiences
Detail-oriented with strong organizational skills and the ability to manage multiple cases and priorities simultaneously
Proficiency in Microsoft Office Suite (Outlook, Excel, Word, OneNote)
CCM, COHN, CPHRM, or other relevant clinical or risk management certifications a plus

WHO WE ARE

TPAC is a Managing General Underwriting firm located in Minneapolis, Minnesota. TPAC’s mission is to change the way healthcare is financed, disclosed and delivered. We need people who value honesty and transparency; people who take ownership and responsibility of whatever they are doing. We seek individuals who value all people and interact with humility and respect; people who like to dig deep into issues, who are curious and who understand life is about more than work. If you believe in TPAC’s mission and share our Core Values, then we would like to talk about how we can make a positive impact together.

Apply Now

Refine Your Search

medical underwriter rn jobs

Clinical Risk Nurse

Lead Medical Coordinator ORR (Bilingual Spanish RN)

Senior Director, Telehealth Operations

Temporary Underwriter

Medical Coordinator

Clinical Risk Manager, Schaumburg (IL, US), Alpharetta (GA, US) and Windsor (CT, US).

Lead Medical Coordinator

Medical Director, DI Underwriting Governance

Senior Director, Ambulatory Services

Care Team Nurse - RN

Medical Stop Loss Underwriting Practice Lead, Accident & Health

System Director of Risk Management

Bilingual Medical Coordinator

Lead Medical Coordinator - Bilingual (English/Spanish)

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