- CVS Health (Albany, NY)
- …will lead a team of about 12-15 colleagues who are responsible for the filing of Stop Loss claims to partner Managing General Underwriter (MGU) and Stop ... a subsidiary of CVS Health as the Manager of Stop Loss /Reinsurance Operations . In this...claims , eligibility, plan setup, implementation) or related field; stop loss /reinsurance experience highly preferred * Progressive… more
- HCA Healthcare (Nashville, TN)
- …liability and coordination of benefit claims in accordance with policy. Review stop loss reports and identify members who are nearing reinsurance levels. ... We care like family! Jump-start your career as a Claims Examiner today with Work from Home. **Benefits** Work...is skilled in physician employment, practice and urgent care operations . We are experts in hospitalist integration, and graduate… more
- BlueCross BlueShield of North Carolina (NC)
- …is responsible for the development, oversight, and execution of all dental operations , including claims adjudication, customer service, appeals, and reporting. ... and scheduling across multiple functions. + Deep working knowledge of dental operations , including claims adjudication, customer service, appeals, and audit… more
- Byline Bank (Chicago, IL)
- …Byline Bank is the place for you. **Objective of Position** : The Deposit Operations Generalist plays a key role in ensuring the effective implementation of bank ... position works closely with supervisors and managers from Deposit Services, Wire Operations , Exception Processing, and Card Services to support daily operations … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …semi-annually to University Board **Risk Management & Actuarial Oversight** + Restructure stop - loss insurance program for $1.3B scale (specific and aggregate ... architect and execute a **$500M growth strategy** , scaling operations from **$800M to $1.3B over three years** ....& Cost Optimization** + Lead negotiations with TPA, PBM, stop - loss carriers, and specialty vendors managing $50M+… more
- HCA Healthcare (Nashville, TN)
- …Group products including Medical, Dental, Vision, Life Insurance, Long Term Disability, Stop Loss , CorePlus Voluntary Benefits, Supplemental Health and other ... practices, performance guarantees and service level agreements. + Oversee operations of Health & Group plans including claims... operations of Health & Group plans including claims administration and employee appeals process. + Work with… more
- Air National Guard Units (Bangor, ME)
- …unsatisfactory participation, retirements, conditional releases, advise commanders' on stop - loss , activation periods, and demobilization, and inter- ... (IDS), critical to deployment/employment of tasked personnel in support of global operations . --Is responsible to the Military Support Flight Commander for the… more
- Amazon (New York, NY)
- …funding and scoring performance compared to plan expectations. -Complete the evaluation of stop - loss coverage and manage third party vendors -Analyze and develop ... of actuarial reserving, forecasting and medical economics -Expertise in working with medical claims data and using programming languages such as SQL, R, SAS, Python,… more
- Northwell Health (New York, NY)
- …TPA account management for renewal distribution and negotiations with the plan vendors ( Stop loss , PBM, etc *Additional Salary Detail The salary range and/or ... progressively related sales experience including experience with products, services, operations , customer service, marketing and sales techniques. *May have some… more
- Southland Industries (Garden Grove, CA)
- …+ Collaborate with Finance and brokers to evaluate self-insured program performance, stop - loss coverage, and claims experience. + Ensure compliance ... to benefits financial planning, while maintaining responsibility for day-to-day operations and employee engagement. The Specialist partners with Finance and… more
- CareFirst (Baltimore, MD)
- …etc. Complete the renewal process on smaller accounts, complete/update ASO and Stop Loss contracts and quote alternate funding arrangements with assistance ... goals through the completion of new business quotes (eg demographics, claims experience, benefit levels, contribution strategy, carrier history, etc.) and the… more