Aetna

Stop Loss Supervisor

Aetna

Amherst, NY, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Are you a highly motivated and experienced professional with a passion for ensuring financial stability and risk management? Aetna is seeking a skilled Stop Loss Supervisor to join our team and oversee our stop loss operations. In this role, you will play a critical role in protecting our company from excessive medical and financial losses by implementing and monitoring stop loss policies and procedures. We are looking for candidates with a strong background in insurance, exceptional leadership skills, and a dedication to delivering exceptional results. If you are ready to take on a challenging and rewarding position, we encourage you to apply today.

  1. Develop and implement effective stop loss policies and procedures to mitigate potential financial risks for the company.
  2. Monitor and analyze stop loss claims data to identify trends and areas of improvement.
  3. Train and supervise a team of stop loss analysts to ensure accurate and timely processing of claims.
  4. Collaborate with other departments, such as underwriting and finance, to establish appropriate stop loss rates and limits.
  5. Conduct regular audits to ensure compliance with company policies and regulatory requirements.
  6. Act as a subject matter expert on stop loss plans and provide guidance to other departments and external partners.
  7. Identify and escalate potential issues or concerns related to stop loss operations to upper management.
  8. Continuously evaluate and improve stop loss processes to increase efficiency and effectiveness.
  9. Stay up-to-date on industry trends and best practices related to stop loss operations.
  10. Foster a positive and collaborative work environment to encourage team productivity and development.
Where is this job?
This job is located at Amherst, NY, USA
Job Qualifications
  • Bachelor's Degree In A Relevant Field Such As Healthcare Management, Business Administration, Or Finance.

  • Minimum Of 3-5 Years Of Experience In Healthcare Claims And/Or Stop Loss Insurance.

  • Strong Knowledge Of Stop Loss Policies, Procedures, And Regulations.

  • Excellent Analytical Skills With The Ability To Interpret Complex Data And Make Sound Decisions.

  • Proven Leadership And Supervisory Experience, Including The Ability To Manage And Develop A Team.

Required Skills
  • Risk Management

  • Financial Analysis

  • Data Analysis

  • Contract Negotiation

  • Claims Processing

  • Team Leadership

  • Contract compliance

  • Problem-Solving

  • Client communication

  • Claims analysis

  • contract Interpretation

  • Provider Relations

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • Time management

  • creativity

  • flexibility

  • Teamwork

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Stop Loss Supervisor in Amherst, NY, USA is $56,000 - $75,000 per year. This may vary depending on the specific company, industry, and level of experience of the supervisor.

Additional Information
Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedMarch 13th, 2025
Apply BeforeNovember 16th, 2025
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About Aetna

Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.

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