Overview

Connie McClure brings to Ubi Cras Stop Loss (UC//SL) more than 30 years of progressive leadership in medical stop-loss / reinsurance claims management, cost containment, and medical risk underwriting evaluation. A seasoned healthcare insurance executive and registered nurse by training, she pairs deep clinical and insurance expertise with a proven track record of aligning medical strategy with business growth.

Connie began her career as a registered nurse in clinical care at Albert Einstein Medical Center before moving into managed care with HCA’s TPA, where as Claims Manager and Precertification Program Coordinator she coordinated medical precertification across a range of health plans and developed the claims policies and procedures that govern high-severity medical exposure.

At Carbon Stop Loss (formerly IOA Re), Connie rose from Nurse Claim Consultant to Reinsurance Claims Manager to Senior Vice President of Reinsurance Claims & Medical Management. There she built and led the medical management and cost containment programs supporting the platform’s reinsurance carriers, TPAs, and captive insurers, with executive oversight of two departments and a high-performing team of 15 through organizational growth from $75M to more than $200M in premium.

Today, as Founder & CEO of CM Risk Management, Connie delivers reinsurance and stop-loss consulting to MGUs, brokers, carriers, reinsurers, and captives — helping clients accurately assess claimant risk for new and renewal underwriting, evaluate in-force business, and validate claim accuracy and medical necessity.

Across each role, Connie has been the clinical conscience of the claims function — bringing the clinical insight and claims expertise needed to control costs and protect profitability. At UC-UW, she leads claims and medical risk management, ensuring every dollar of medical exposure is reviewed with clinical rigor its reinsurers and partners can verify.

Highlights

• Senior Vice President, Reinsurance Claims & Medical Management, Carbon Stop Loss (formerly IOA Re) – led claims operations, clinical oversight, and cost containment

• Founder & CEO, CM Risk Management – stop-loss and reinsurance consulting for MGUs, brokers, carriers, and reinsurers

• Executive oversight of two departments supporting premium growth from $75M to $200M+

• Registered Nurse; B.S. in Nursing, York College – Member, RGA Claims Council