Role Overview and Offer Details

This Clinical Risk Management Nurse role is a full-time, permanent contract with a competitive salary and robust benefits package based on experience level.

Professionals selected for this post work with Universal Healthcare, an established provider trusted by multiple insurance plans.

Work hours are office-based, Monday through Friday, and strict confidentiality regarding patient information is required.

This position is ideal for enrolled or registered nurses aiming for stability and growth in their career path.

Only candidates registered with the applicable Health Professions Council will be considered.

Daily Responsibilities and Duties

Your primary focus will be evaluating healthcare claims and communicating with high-service users and healthcare providers.

You will handle outbound calls to assess the necessity of care, educate members, and liaise with doctors for complex cases.

Other key tasks include supporting investigations to prevent fraud, waste, or abuse, and managing general practitioner authorisation requests.

Prompt and professional call handling, strict data logging, and adherence to service level agreements are vital.

Keeping current on policy and protocol updates is necessary to perform well in this dynamic role.

Main Pros of the Position

The role offers real stability due to its permanent contract status, along with a competitive salary and additional benefits.

Career development is encouraged, and day-to-day work is impactful, helping optimise healthcare delivery and reduce system inefficiencies.

Potential Cons to Consider

Continuous telephone engagement and case management may be demanding for those who prefer a more hands-on, clinical environment.

Requirement for strict confidentiality and policy adherence may feel restrictive to some professionals.

Final Verdict

This position is highly suitable for a dedicated, communicative nurse looking for a challenging, professionally rewarding role with strong prospects.

If you are detail-oriented, organised, and ready to make a tangible difference in healthcare efficiency, this job could be a perfect fit.