Reinsurance Operations Senior Manager

Job Description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

Join Meritain, a subsidiary of CVS Health as the Senior Manager of Stop Loss/Reinsurance Operations. In this high impact role, you will lead a team of 20+ colleagues who are responsible for the filing of Stop Loss claims to partner MGU and Stop Loss Carriers, follow up, reconciliation and posting of Stop Loss reimbursements. As Senior Manager, you will lead day to day colleague management, as well as issue resolution. You will be responsible for partnering across the Meritain organization, representing Meritain in conversation with Stop Loss carrier partners and for overall departmental performance.

The ideal candidate will be an Operational innovator, able to seamlessly move between strategic and tactical assignments as well as posses advanced communication skills, both verbal and written.

Additional Responsibilities:

• Receives and investigates escalated and complex cases and works with Management and other departments to bring about resolution.
• Provides direction for the Stop Loss staff in meeting their developmental goals.
• Oversees the daily workflow and priorities to ensure business objectives are maintained.
• Maintains monthly reporting statistics for Management
• Participates in weekly prioritization process for system enhancements
• Develops and maintains inter-departmental relationships necessary for teamwork and completion of objectives and goals.
• Responsible for managing training requirements for new and existing staff
• Build and maintain relationships with stop loss carriers to expedite urgent or special issues.
• Fosters environment of compliance per Aetna requirements.
• Functions as back-up to staff and peers as necessary

Required Qualifications

• 5+ years Leadership experience in a Health Care or Insurance setting

Preferred Qualifications

• Prior experience managing large teams
• Prior experience working with multiple Stop Loss / Reinsurance partners
• Medical Claims Operations exposure

Education

• Bachelor’s Degree or equivalent experience.

Pay Range
The typical pay range for this role is: $75,400.00 – $166,000.00.

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 03/27/2024

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. 

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.