Senior Manager, Medical Stop Loss
- Bellevue, WA
Symetra has an excellent opportunity to join our Benefits division as a Stop Loss Claims Senior Manager!
About the role
The Stop Loss Claims Senior Manager will establish operational strategy for the Benefits Division Stop-Loss Claims department in support of the business unit's priorities, drive execution of critical initiatives and achieve targeted outcomes, ensure compliance with the Affordable Care Act and other regulatory and company standards, maintain strong risk management subject area and quality assurance metrics in the claims review process, and utilize continuous improvement management initiatives to deliver results and maintain high-performing team culture.
What you will do
- Lead a team of approximately 8-10 Stop-Loss professionals, and all aspects of quality controls, workflows and processes to ensure timely and accurate payment of Stop-Loss claims
- Build and maintain a positive relationship with internal and external customers, including other business divisions Create a team environment of employee engagement designed to improve empowerment, accountability and outstanding customer service.
- Handle the department budget to ensure cost-effective claims management and oversee department administrative matters
- Be responsible for the review settlement of certain large, critical claims. Collaborate with team members, peers, the VP of claims, the legal and compliance departments to settle certain complex claims. Oversee responses to insurance department inquiries, consumer complaints, etc. Research, document and communicate issues to senior management appropriately for resolution and/or prevention
- Prepare and distribute Stop-Loss claims metrics reports. Partner and collaborate with appropriate parties in facilitating system and workflow enhancements and development, as well as defining and prioritizing systems needs in relationship to business and users' needs.
- Act as primary Stop-Loss claims department liaison for internal and external audits. Update, maintain and communicate documented workflow updates for the Stop-Loss claims team, to include Internal Audit Services, SOXBOX, etc.
We don't take a "one-size-fits-all" approach when it comes to our employees. Our programs are designed to make your life better-both at work and at home.
- Flexible work program and telecommute arrangements
- Wellness program offering employees a variety of resources crafted to assist you in reaching and maintaining your optimum health
- Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%
- Paid time away including vacation and sick time, flex days and ten paid holidays
- Give back to your community and double your impact through our company matching
- Want more details? Check out our Symetra Benefits Overview
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