Stop Loss Operations Manager
Employment Information
Job Description
Join CVS Health as Manager of Stop Loss/Reinsurance Operations. Lead a team managing Stop Loss claims and reimbursements in a high-energy, fast-paced environment.
Responsibilities:
- Join a team of about 12-15 colleagues who are responsible for the filing of Stop Loss claims
- Follow up, reconciliation and posting of Stop Loss reimbursements
- Lead day to day colleague management, as well as issue resolution
- Partner across the Meritain organization, representing Meritain in conversation with Stop Loss carrier partners
- Oversee the daily workflow and priorities to ensure business objectives are maintained
- Maintain monthly reporting statistics for Management
- Participate in weekly prioritization process for system enhancements
- Manage training requirements for new and existing staff
- Build and maintain relationships with stop loss carriers to expedite urgent or special issues
- Foster an environment of compliance per Aetna requirements
Requirements:
- Minimum 5 years operations (claims, eligibility, plan setup, implementation) or related field; stop loss/reinsurance experience highly preferred
- Progressive leadership experience managing projects and/or teams
- Health Care or Insurance setting
- Prior experience managing large teams
- Medical Claims Operations exposure
- bachelor’s degree preferred/specialized training/relevant professional qualification.
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
- Many other benefits depending on eligibility.
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