• Review and analyze clinical data to assess potential stop loss claim liabilities • Provide cost projections on high-dollar claimants to support underwriting decisions • Utilize case management techniques to ensure effective cost containment and management of high-risk claims • Work closely with Third Party Administrators (TPAs), case managers, and internal teams to ensure effective communication and management of clinical information • Maintain accurate and detailed documentation of clinical assessments, cost projections, and case management activities • Identify high-risk individuals and communicate required stop loss cost analysis based on current clinical conditions and future cost projections • Prepare and present reports on clinical risk assessments and cost projections to senior management