Associate in Model Risk Management role within Financial Services Group analyzing financial risks. Support senior members with model validation, risk assessments, and deliver reports.
About the role
- Clinical Nurse Risk Strategist translating complex medical and pharmacy data into actionable insights for employers. Collaborating with teams to support cost management and health outcomes.
Responsibilities
- Analyze medical and pharmacy claims, eligibility, utilization, and related healthcare data to identify high-cost drivers, emerging risk, chronic and catastrophic conditions, and material shifts in cost and utilization
- Apply clinical judgment to interpret treatment pathways, disease progression, and utilization patterns to identify where risk and cost can be actively managed
- Use data review to position findings as opportunities for intervention, prioritization, and strategic focus
- Support high-cost claimant and large-claim reviews by synthesizing clinical context and cost trends into actionable insights and clear recommendations
- Translate complex clinical and financial findings into executive-ready insights that inform cost management, benefit strategy, and employer decision-making
- Align identified findings with appropriate clinical, wellbeing, navigation, or cost-containment solutions based on data-driven rationale
- Lead the development and delivery of client-facing materials that clearly articulate implications, opportunities, and recommended actions
- Partner with consultants, service teams, analytics partners, and the internal team to shape strategic narratives, align on priorities, and prepare for client discussions
- Clearly communicate data limitations, assumptions, and methodological considerations to ensure appropriate interpretation and use of insights
- Serve as a clinical and analytical subject matter expert for internal stakeholders, including consulting, wellbeing, underwriting, and leadership teams
- Contribute to the development and standardization of reporting templates, insight libraries, and clinical review best practices
- Support internal enablement, mentoring, and knowledge-sharing related to clinical interpretation, insight quality, and effective use of claims-based analytics
Requirements
- Demonstrated experience analyzing medical and pharmacy claims data in support of employer-sponsored health plans, captives, or stop-loss environments within a healthcare analytics or benefits consulting setting
- Strong understanding of chronic condition management, utilization drivers, and healthcare cost dynamics
- Ability to translate data into actionable, decision-oriented insights, not just report metrics
- Advanced proficiency in Excel and PowerPoint with the ability to produce polished, executive-ready deliverables
- Ability to clearly communicate complex clinical and analytical concepts to non-clinical audiences
- Active clinical license required (RN)
- Bachelor of Science in Nursing (BSN) strongly preferred
Benefits
- Comprehensive medical insurance, dental insurance, and vision insurance
- Life and disability insurance
- Fertility benefits
- Wellness resources
- Paid sick time
- Generous paid time off and holidays
- Employee Assistance Program (EAP)
- Complimentary Calm app subscription
- Immediate vesting in a 401(k) plan
- Health Savings Account (HSA) and Flexible Spending Account (FSA) options
- Commuter benefits
- Employee discount programs
- Paid maternity leave and paid paternity leave (including for adoptive parents)
- Legal plan options
- Pet insurance coverage
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Senior Supervisory Control Specialist overseeing compliance and supervisory practices within Wealth and Investment Management. Collaborating with business partners to mitigate risks while ensuring adherence to regulations.
Risk Management & Insurance Intern role at Orchid Insurance in Tampa, FL. Participating in a 6 - week summer internship program focused on risk management and insurance fundamentals.
Intern supporting climate risk and exposure analytics at USAA with modeling and data analysis for catastrophe management. Collaborating across teams to address climate impacts and improve resilience strategies.
Senior Operational Risk Officer providing oversight and risk management expertise for KeyCorp's Consumer Bank. Engaging with business units to ensure effective operational risk management practices.
Governance Strategist for ITGC and Identity & Access Management at Truist. Coordinating governance structures and driving risk management initiatives across technology teams.
MB
Customer Complaint Resolution Specialist in the Customer Advocacy team addressing escalated complaints. Conducting investigations, preparing executive - level responses, and advocating for better customer experiences at M&T Bank.
Manager of Information Governance and Privacy overseeing compliance and incident investigations at CVS Health. Fostering privacy culture and risk remediation for Health Services Segment.
Technology Risk and Control Associate managing technology risk and analytics at AIG. Involved in risk assessments, reporting, and working with technology teams for compliance.
Market Risk Manager providing oversight of capital markets products at State Street. Ensuring risk analysis and compliance with regulations while analyzing balance sheet risk management frameworks.