Director of Stop Loss

2 months ago

Chicago, United States Hueman PE Talent Solutions Full time
Job DescriptionJob Description

Point C Health is hiring a Director of Stop Loss for a full-time remote position.

Must be able to work EST and CST hours.

The Director of Stop Loss will provide strategic planning and consulting to clients on Stop Loss Coverage, acting as the primary expert within the Stop Loss team. This role involves managing vendor relationships, negotiating plan terms, understanding industry trends, and leading a team to ensure client satisfaction and retention. This role will also support new business generation, client renewals, and the implementation of stop-loss programs.

Point C is a private equity backed platform of third-party administrators (TPAs) focused on providing services to businesses that self-fund their medical benefits. Point C actively acquires independent and 'like-minded' TPAs within the continental US, encouraging each partner to retain their unique local identities while creating value at the platform level through centralizing back-office functions, improving technology, and optimizing vendor relationships. The Point C Corporate team supports each partner while leading strategic investments in resources and systems, facilitating sharing of best practices, and implementing value-creation initiatives across the entities.

Job Requirements:

  • Provide expert advice on Stop Loss Coverage strategies to clients.
  • Collaborate with internal SMEs to optimize client satisfaction and retention.
  • Act as the primary contact for vendor partners, negotiating plan terms and overall design changes.
  • Maintain and develop knowledge of group medical stop loss products, underwriting principles, and Point C’s product portfolio.
  • Collect, review, and prepare data for market quotes on stop loss programs.
  • Research industry trends, carrier offerings, and emerging trends to inform strategic decisions.
  • Lead a team in executing client renewals and providing strategic guidance.
  • Support new business generation by collaborating with Sales Directors, acting as a technical SME, and leading the RFP process.
  • Provide on-the-spot strategic guidance and financial performance information during client meetings.
  • Ensure completion of client reports and administrative tasks such as Form 5500 filings, policy checking, and delivery of SPDs.
  • Act as a trusted advisor by developing strong client relationships through effective communication and project execution.
  • Oversee the development and production of Requests for Proposal (RFPs), analyze responses, and prepare client reports with recommendations.
  • Use discretion and independent judgment in analyzing industry trends and providing feedback.
  • Supervise, mentor, and train team members to meet or exceed industry standards.
  • Identify and address client service issues, developing and implementing processes to enhance service quality.
  • Maintain awareness of large and complex claims, assist with negotiations, and resolve claim settlements.
  • Develop underwriting analyses for prospective entrants into the Point C stop loss program.
  • Review agreements and documents related to client stop loss coverage, including policies and ASO agreements.
  • Assist with monthly reporting and issue resolution, including gray claims.
Qualifications:
  • Bachelor’s Degree in Business Administration or a related field, or equivalent experience.
  • Minimum of 7 years in the insurance industry, specifically in employee welfare benefits.
  • Strong knowledge of stop loss/reinsurance and TPA vendors.
  • Excellent customer service and client relationship development skills.
  • Proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint).
  • Strong understanding of vendor and competitor strengths and weaknesses.
  • Superior interpersonal communication and critical thinking skills.
  • In-depth knowledge of industry trends and governmental regulations.
  • Ability to protect confidential information and work effectively in a fast-paced environment.

Work Environment:

Fully remote, flexibility with schedule around general business hours. Must have reliable internet and familiarity with digital platforms.

CST and EST locations are preferred, with occasional travel.

Equal Employment Opportunity

At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

At Point C Health, we believe there is immense power when bright minds work together around a common purpose. At the heart of their mission is the individual—a person who deserves the same kind of support and care they would provide their own family. If you would like a rewarding career with a growing company, this opportunity is for you.

If you are interested in learning more about a career with Point C Health as a Director of Stop Loss, apply today

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