[Hiring] Clinical Risk Manager @Ryan Specialty

Role Description

Ryan Specialty Benefits is seeking an experienced and clinically driven Clinical Risk Manager to join our dynamic Clinical Advisory Team. This is a unique opportunity to play a critical role within a rapidly growing organization that is redefining clinical risk management and stop loss cost containment.

As a Clinical Risk Manager, you will serve as a strategic clinical consultant, partnering closely with our brokers, carrier partners, TPAs, captive programs, specialty vendors, and employer-sponsored health plans to identify risk, evaluate high-cost claims, and develop innovative cost mitigation strategies. Your expertise will directly influence underwriting decisions, risk management initiatives, and financial outcomes for our clients.

This role is ideal for a clinically experienced Registered Nurse who enjoys combining clinical expertise with financial analysis, strategic problem-solving, and collaborative relationship management. You will become part of a highly engaged team focused on delivering meaningful results through clinical insights, proactive risk identification, and innovative mitigation solutions.

What You'll Do

• Clinical Risk Assessment & Analysis
  • Analyze medical and pharmacy claims, clinical records, treatment plans, and emerging therapies to identify high-cost claim exposure and stop loss risk.
  • Evaluate current and future claim liabilities, including complex cases involving oncology, transplants, specialty pharmacy, gene and cell therapy, catastrophic claims, and chronic conditions.
  • Assess clinical severity, treatment patterns, and emerging risks to support stop loss underwriting and risk management decisions.
• Cost Projection & Financial Modeling
  • Develop accurate clinical cost projections for high-dollar claimants and complex cases.
  • Monitor significant ongoing claims and identify potential changes in risk exposure.
  • Provide detailed financial analyses and forecasting that support underwriting, renewal, captive, and carrier decision-making.
• Risk Mitigation Strategy Development
  • Partner with brokers, carriers, TPAs, case management teams, specialty vendors, and employer groups to identify opportunities for cost containment and risk reduction.
  • Evaluate and recommend clinical and financial mitigation solutions, including:
    • Specialty pharmacy optimization
    • Biosimilar conversion opportunities
    • Site-of-care management
    • Centers of Excellence utilization
    • Case management intervention
    • Transplant management programs
    • Gene and cell therapy solutions
    • Alternative funding and assistance programs
  • Collaborate with internal and external stakeholders to implement effective cost-management strategies that improve outcomes while controlling plan spend.
• Captive and Client Support
  • Support captive risk management initiatives through ongoing clinical reviews and risk assessments.
  • Present complex clinical information in a concise, actionable manner for clients, brokers, captives, carrier partners, and executive leadership.
  • Serve as a trusted clinical resource during renewal discussions, prospect evaluations, and risk management consultations.
• Collaboration & Relationship Management
  • Work closely with Ryan Specialty Benefits consultants, producers, underwriting partners, TPAs, brokers, carriers, and specialty vendors.
  • Foster strong strategic relationships that support innovative client solutions and exceptional service delivery.
  • Participate in multidisciplinary discussions to identify trends, share best practices, and improve overall risk management outcomes.
• Reporting & Documentation
  • Maintain accurate documentation of clinical analyses, cost projections, and mitigation recommendations.
  • Prepare reports, presentations, and executive summaries that communicate clinical risk and financial impact to diverse audiences.
  • Monitor outcomes and effectiveness of implemented mitigation strategies.

Qualifications

• Associate's or Bachelor's Degree in Nursing or a related healthcare field preferred.
• Minimum of 3 years of clinical nursing experience.
• Minimum of 2 years of stop loss captive risk management required.
• Experience evaluating complex and catastrophic claims strongly preferred.
• Active and unrestricted Registered Nurse (RN) license.

Benefits

• Comprehensive and best-in-class benefits package.
• Paid time off for company holidays, vacation, sick and personal days.
• Paid parental leave.
• Mental health services.