Senior Manager, Stop Loss Filling

🕒 August 17

🇺🇸 United States – Remote

💵 $80k - $90k / year

⏰ Full Time

🟠 Senior

👔 Manager

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Point C

WebsiteLinkedInAll Job Openings

201 - 500 employees

🛡️ Insurance

💼 Consulting

📦 Logistics

Insurance • Consulting • Logistics

Point C is a trusted health benefits partner that delivers meaningful solutions for brokers and their self-funded clients. The company specializes in administering benefit plans, managing medical costs effectively, and ensuring a high-value experience for members. With a focus on vendor integration and data-driven insights, Point C aims to simplify the benefit process while providing access to quality care and innovative mobile tools for its clients and their employees.

📋 Description

• Lead the Stop-Loss Operations function, including policy setup, filing accuracy, laser and disclosure management, renewals, and claims reimbursement submissions • Integrate stop-loss sub-teams operating on different legacy platforms, workflows, and quality standards into one operating model • Design and enforce controls for zero processing errors and compliance with carrier, regulatory, and contractual requirements • Develop standardized SOPs, quality-audit routines, error tracking, root-cause analysis, and corrective actions • Oversee and coach stop-loss team leads and staff, including performance management, capacity planning, and career development • Partner with Account Management, Sales, Client Services, carriers, and MGUs on stop-loss matters, filings, coverage questions, escalations, renewals, and issue resolution • Build and report KPIs and SLAs to executive leadership • Support platform migration, including the QicLink-to-VBA transition, for stop-loss data, workflows, and system configuration • Identify broader Operations process gaps and champion a systems-over-silos approach

🎯 Requirements

• 7+ years of progressive stop-loss experience at a TPA, carrier, MGU, or reinsurer, including direct management of a stop-loss operations team • Established relationships with stop-loss carriers and MGUs, including carrier communication, filings, escalations, renewals, and disputes • Demonstrated success integrating or consolidating teams using different legacy systems, workflows, or standards • Deep knowledge of specific and aggregate stop-loss coverage, lasers, disclosure requirements, run-in/run-out, and claims reimbursement processes • Experience building or overhauling processes to drive error rates toward zero and maintain full compliance • Strong cross-functional partnership, credibility, and communication skills • Ability to operate in a fast-moving, private-equity-backed environment undergoing platform migration and acquisition integration • Experience with QicLink, VBA, or comparable TPA core administration platforms strongly preferred • Experience with Ringmaster or comparable TPA stop-loss filing software strongly preferred • Excellent written and verbal communication skills, including translating operational detail into executive updates

🏖️ Benefits

• Comprehensive medical, dental, vision, and life insurance coverage • 401(k) retirement plan with employer match • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) • Paid time off (PTO) and disability leave • Employee Assistance Program (EAP) • Potential bonuses and merit increases for eligible roles