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Clinical Nurse Risk Strategist

Job in Pittsburgh, Allegheny County, Pennsylvania, 15289, USA
Listing for: Acrisure
Full Time position
Listed on 2026-09-11
Job specializations:
  • Business
    Data Analyst
Salary/Wage Range or Industry Benchmark: 70000 - 90000 USD Yearly USD 70000.00 90000.00 YEAR
Job Description & How to Apply Below

About Acrisure

A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting‑edge technology and top‑tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more. In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries.

Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.

Job Summary

The Clinical Nurse Risk Strategist translates complex medical and pharmacy claims data, along with other relevant healthcare data sources, into actionable insights that help employers manage cost, improve health outcomes, and make informed benefit strategy decisions. The role applies clinical risk assessment and advanced claims analysis to identify opportunities to manage risk and cost, develop data‑informed recommendations, and produce executive‑ready insights.

The Clinical Risk Strategist works closely with consultants, service teams, analytics partners, and the internal team to inform interpretation, shape strategic narratives, and support intentional, data‑driven benefit and cost management decisions for employer clients.

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…
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