- 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
- 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
- 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
- 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
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