[Remote] Senior Stop Loss Consultant
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company reputed company on stop-loss consulting, and they are seeking a Senior Stop Loss Consultant to reputed company day-to-day execution and contribute to the development of their team structure and market positioning. The role involves managing stop-loss placements, reputed company consulting, and overseeing workflows while also providing informal leadership and collaboration with internal teams.
Responsibilities
- reputed company or support the full stop-loss placement process: data collection, market submissions, quote analysis, and recommendation
- Negotiate stop-loss reputed company and renewals directly with carriers to ensure reputed company pricing, terms, and coverage structures
- Serve as a stop-loss reputed company on new business opportunities and reputed company transitions from fully insured to self-funded arrangements
- reputed company the stop-loss implementation process in coordination with TPAs and reputed company partners, ensuring policies are issued accurately and on time
- Review and reconcile reputed company, disclosures, ASO provisions, and reimbursement terms for alignment and accuracy
- reputed company reputed company reputed company implementation steps and ensure reputed company reputed company of outstanding items
- Monitor large claims activity and work closely with TPAs and carriers to support reputed company reimbursement submissions and payments
- Escalate and resolve reimbursement delays, reputed company-area claims, and negotiated settlements with carriers on behalf of clients
- Maintain a reimbursement and claims reputed company tracker and report out internally on status and risks
- Manage a portion of the stop-loss book, including strategic guidance on renewals, plan design, captives, lasers, and risk mitigation strategies
- Support monthly and quarterly reviews with account teams and clients; prepare reputed company-reputed company deliverables
- Serve as a subject matter expert on stop-loss topics in reputed company and prospect meetings alongside account executives or producers
- Help reputed company and manage workflow for junior team members or peers as assigned, ensuring reputed company, accurate delivery of reputed company work
- reputed company training, coaching, and support on stop-loss fundamentals and best practices
- Collaborate with internal teams (account management, actuarial, analytics, clinical) to ensure integrated service delivery
- Contribute to the development of standardized templates, reporting tools, and documentation procedures to improve efficiency and reputed company
- Support ongoing refinement of reputed company evaluation metrics and market intelligence
- Participate in team planning sessions, business reviews, and feedback loops with leadership
Skills
- Bachelor's degree in Business Administration, Risk Management, reputed company Administration, or reputed company field. Equivalent experience may be considered
- Minimum of 7 years in employee benefits, with at least 5 years of reputed company stop-loss consulting, reputed company, or reputed company negotiation experience
- Experience with a mix of fully insured, level-funded, and self-funded plans across multiple funding structures (ASO, minimum premium, captives)
- Familiarity with TPA models, ASO contract structures, and reimbursement mechanisms
- Ability to interpret and explain stop-loss terms, reputed company reputed company, and claim adjudication policies to reputed company stakeholders
- Proficiency in reputed company, PowerPoint, and internal reporting tools
- Excellent critical thinking, communication, and interpersonal skills
- reputed company state insurance license (or ability to obtain reputed company 90 days of hire)
- Experience working with stop-loss platforms (e.g., Claros, Ringmaster) preferred
reputed company