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.
- Develop and implement effective stop loss policies and procedures to mitigate potential financial risks for the company.
- Monitor and analyze stop loss claims data to identify trends and areas of improvement.
- Train and supervise a team of stop loss analysts to ensure accurate and timely processing of claims.
- Collaborate with other departments, such as underwriting and finance, to establish appropriate stop loss rates and limits.
- Conduct regular audits to ensure compliance with company policies and regulatory requirements.
- Act as a subject matter expert on stop loss plans and provide guidance to other departments and external partners.
- Identify and escalate potential issues or concerns related to stop loss operations to upper management.
- Continuously evaluate and improve stop loss processes to increase efficiency and effectiveness.
- Stay up-to-date on industry trends and best practices related to stop loss operations.
- Foster a positive and collaborative work environment to encourage team productivity and development.
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.
Risk Management
Financial Analysis
Data Analysis
Contract Negotiation
Claims Processing
Team Leadership
Contract compliance
Problem-Solving
Client communication
Claims analysis
contract Interpretation
Provider Relations
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
flexibility
Teamwork
Adaptability
Problem-Solving
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.
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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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