Senior Manager, Stop Loss Client Support

3 weeks ago

West Bloomfield Township, Michigan, United States The Cigna Group Full time
The job profile for this position is Strategic Planning Senior Manager, which is a Band 4 Management Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

Position Summary:

The primary responsibility of this role is to ensure a seamless experience for Cigna's stop loss clients. This role leads the team responsible for the process of case setup and install ensuring that the Reimbursement team can operate and service clients in a timely, efficient, and accurate manner. This team is also responsible for formal and informal communications to clients and client managers including contract generation and delivery and facilitating complaint and dispute resolution as necessary, as well as facilitating the administration and support of third party carveout stop loss.

In addition, this role will play a key role in the development, administration, and execution of relationships with Stop Loss producers including the oversight of clinical resources dedicated to supporting producer inquiries. This includes ensuring accurate reimbursement for producers, evaluation of agreement effectiveness, and supporting negotiation and execution of contracts in conjunction with Senior Leadership and the Producer Relations team.

This role is a key member of the Stop Loss leadership team. The ideal candidate will be self-reliant in turning vision and ideas into an approach to get targeted results and work with an enterprise mindset across all impacted matrix partners to drive the development and execution of new or updated processes. Comfort in and prior exposure to Healthcare Business, Project Management framework and Change Management will support strong performance in this role.

Essential Functions:

  • Accountable for driving and achieving business results including high levels of client satisfaction with implementation, productivity, quality, and employee satisfaction. This includes identification of trends, root cause issues and developing appropriate action to drive resolution or maintain positive results.
  • Supports departmental leadership in developing and implementing strategic business work plans/goals, inclusive of leading long and short-term projects.
  • Manages and supports the administration, development, and execution of relationships with Stop Loss producers including reporting on performance and business recommendations.
  • Develop and Interrogate system and manual process to recommend best process to ensure both sustainability and efficiency to enable capacity to be deployed to new work.
  • Develops and manages resourcing forecasts to address business needs.
  • Accountable for talent management inclusive of developing talent pools, hiring/onboarding, goal setting, developing employee's skills, evaluating performance, providing feedback, and creating a culture of engagement, enablement, and a positive work environment.
  • Grows the efficiency of existing organizational processes and procedures to enhance and sustain the organization's internal capacity.
  • Serves as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
  • Partners with, and supports, Stop Loss IT Liaison in the delivery of strategic projects representing business initiatives to deliver long-term improvements to the organization.
  • Ensures department is operating in compliance of state regulations surrounding application/contract issuance, claim reimbursements and reporting requirements.
  • Serve as a mentor and coach for team on the topic of change management and growth mindset.
  • Lead a team of 9 subject matter experts across three teams (Stop Loss Account Management, Contract Analysts, and Producer Clinical Support).

Qualifications:

  • At least 10 years of experience in a healthcare leadership position, preferably with a focus on operations within a production environment.
  • Skills and comfort in ability to create and achieve success by negotiating and problem-solving in complex organizations / highly matrix management environments.
  • Strong written & verbal communication skills, including presentation skills in front of a senior / external audience. Comfortable explaining complex concepts to audiences with various levels of knowledge of the subject.
  • Ability to manage change, negotiate and influence to drive change through the organization.
  • Ability to lead a highly skilled team, providing critical support and direction while enabling resources to work autonomously.
  • Critical thinking to make quick and accurate real-time decisions to flex and deploy resources to deliver a positive client experience.
  • Capability to delegate responsibilities while maintaining organizational control of operations and client service.
  • Demonstrated experience in managing a high performing remote team through clear communication, goal setting, coaching, development, and employee engagement.
  • Ability to personally dig deep into business challenges and leverage others within the organization to develop solutions and best practices.
  • Strong analytical, root cause analysis, and critical thinking skills.
  • Demonstrated problem solving and collaboration in a complex matrix environment.
  • Meticulous with emphasis on quality /accuracy.
  • Stop Loss or Reinsurance experience preferred.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

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