Medical Risk Consultant (RN)
Virtue Health · United States · US
Healthcare Consulting
Remote
Nurse
Dentist
Demand82
Career growth75
Healthcare fit78
Remote potential100
5-year outlook
Likely competitive for experienced RNs with payer-side and stop-loss expertise; compensation may grow with specialization in clinical risk and laser advocacy, but exact figures depend on employer, location, and experience.
Clinical license
Required
Applicant reach
narrow
Seniority
senior
Employment type
full-time
Date found
2026-10-02
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying for experienced RNs with payer-side case management or utilization review background who want a remote, high-impact non-clinical role in stop-loss risk. Not suitable for clinicians without payer experience or CCM.
Who should apply
ICU, oncology, transplant, or complex chronic care RNs with 3+ years in case management, utilization review, or payer-side roles at TPA, HMO, PPO, stop-loss carrier, or reinsurance firm; CCM-certified nurses with compact licenses.
CV angle
Frame acute care experience as clinical risk assessment and high-cost trajectory identification; highlight payer-side case management, utilization review, stop-loss, TPA, and underwriting collaboration; quantify complex/catastrophic case management and cost containment outcomes; emphasize CCM, compact RN license, and written clinical assessment skills.
Skills to highlight
- Clinical risk assessment
- Medical record review
- Stop-loss and self-funded plan knowledge
- Case management
- Utilization review
- Underwriting collaboration
- Laser advocacy
- Cost containment
Role summary
Remote RN role performing clinical risk reviews for stop-loss claims, producing written assessments for underwriters and TPAs, advocating on laser reduction at renewal, and supporting cost containment program development.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.