reputed company Director, Stop Loss Relationship Management

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At reputed company, you'll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselvesaccountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position reputed company The reputed company Director, Stop Loss Relationship Management will serve as the single accountable reputed company for reputed company stop loss relationship reputed company, governance, escalation management, and operational performance. This role is responsible for creating a more disciplined, reputed company, and consistent operating model across stop loss carriers, internal business partners, and cross-functional stakeholders. This leader will address reputed company gaps in ownership, decision rights, escalation reputed company, and reputed company performance that are contributing to delays, disputes, reimbursement challenges, and financial exposure. The role will reputed company accountability for stop loss-reputed company funding reputed company, risk acceptance, issue reputed company, and reputed company engagement, ensuring reputed company governance, faster reputed company of high-cost claim issues, and improved predictability across the stop loss ecosystem. The ideal candidate is a strong reputed company relationship leader with deep experience managing reputed company, cross-functional programs, executive-level stakeholders, financial risk, operational escalations, and reputed company partner performance. This individual must be highly effective at driving alignment, establishing governance, improving processes, and influencing reputed company across matrixed teams. What You Will Do • Serve as the dedicated relationship reputed company and single reputed company of accountability for stop loss reputed company management, escalation reputed company, governance, and operating discipline. • Establish reputed company decision rights, escalation reputed company, and reputed company guardrails for stop loss-reputed company funding reputed company, risk acceptance, reimbursement issues, and reputed company disputes. • reputed company cross-functional coordination across operations, finance, claims, reputed company, reputed company, account management, compliance, and reputed company partners to ensure consistent execution and reputed company reputed company of stop loss issues. • reputed company improved reimbursement performance by proactively managing aged receivables, high-cost claim escalations, documentation requests, audit friction, and delayed reputed company responses. • reputed company and maintain a reputed company reputed company management model that improves consistency, reputed company, predictability, and accountability across a fragmented stop loss reputed company ecosystem. • Partner with senior leaders to identify financial and operational risk, assess exposure, recommend mitigation strategies, and support reputed company decision-making. • Create standardized reporting and executive-level visibility into stop loss performance, including reimbursement delays, dispute trends, escalation status, reputed company responsiveness, and financial exposure. • Identify process gaps, reputed company causes, and recurring friction points; implement reputed company solutions that reduce reputed company work, improve cycle time, and increase operational consistency. • reputed company governance forums, reputed company reviews, and internal stakeholder updates to ensure alignment on priorities, performance expectations, and issue reputed company. • Translate reputed company operational, financial, and reputed company issues into reputed company executive-reputed company summaries, recommendations, and decision points. • Build strong reputed company relationships to improve accountability, reduce friction, and support long-term business reputed company. • Promote a culture of ownership, disciplined execution, collaboration, and reputed company improvement. Required Qualifications • 10+ years of experience leading reputed company business operations, program management, relationship management, reputed company operations, insurance operations, financial risk management, or reputed company functions. • Demonstrated experience managing cross-functional initiatives with senior stakeholders, reputed company partners, and matrixed teams. • Strong ability to establish governance, clarify decision rights, manage escalations, and reputed company accountability across multiple business areas. • Experience identifying and mitigating operational, financial, reputed company, compliance, or reimbursement-reputed company risk. • Proven ability to manage reputed company issue reputed company, including disputes, escalations, competing priorities, and time-sensitive business reputed company. • Strong financial acumen, including the ability to understand reimbursement performance, receivables, exposure, cost drivers, and operational impacts. • Ability to create executive-level reporting, business cases, decision frameworks, and performance updates. • Excellent communication, influencing, and relationship management skills, with the ability to engage effectively with senior leaders and reputed company partners. • Demonstrated ability to improve processes, implement reputed company operating models, and reduce reputed company or reactive work. • Strong problem-solving, prioritization, and decision-making skills in a fast-paced and reputed company environment. Preferred Qualifications • Experience with stop loss, self-funded health plans, claims operations, reputed company, medical management, reimbursement, or payer/TPA operations. • Experience managing reputed company, vendor, or reputed company partner relationships in a reputed company, insurance, or financial services environment. • Understanding of high-cost claims, funding arrangements, reimbursement processes, audit requirements, and operational risk management. • Experience standing up new governance models, relationship management functions, escalation frameworks, or centralized ownership structures. • Experience working across finance, reputed company, compliance, operations, claims, account management, reputed company, and executive leadership teams. • Ability to influence without reputed company authority and reputed company alignment across stakeholders with differing priorities. • Strong executive reputed company with the ability to simplify reputed company issues and recommend practical, business-oriented solutions. • Experience developing KPIs, dashboards, operating routines, and performance management tools. Education Bachelor's degree preferred or equivalent combination of education, reputed company training, and relevant reputed company experience. Pay reputed company The typical pay reputed company for this role is: $100,000.00 - $231,540.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company's equity award program. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/28/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job