Stop Loss Operations Manager

Job not on LinkedIn

2 days ago

🌽 Illinois – Remote

Although this job is listed in Illinois, this company may be open to hiring remote in other states.

🗽 New York – Remote

Although this job is listed in New York, this company may be open to hiring remote in other states.

+3 more states

🌽 Illinois – Remote 🗽 New York – Remote 🏈 Ohio – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $54.3k - $159.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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CVS Health

WebsiteLinkedInAll Job Openings

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• 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.