Lead a high-impact stop loss operations team from home while staying close to the action in group health and self-funded plans. This fully remote Manager, Stop Loss role is ideal if you know stop loss inside and out and want to own both people leadership and process improvement.
About Allied Benefit Systems
Allied Benefit Systems is a Chicago-based third-party administrator (TPA) focused on flexible, self-funded group health plans for employers nationwide. The Stop Loss team helps protect client plans from large claims, ensuring accurate filings, timely reimbursements, and strong carrier relationships. As Manager, Stop Loss, you’ll guide the day-to-day operations of this function and drive continuous improvement.
Schedule
- Full-time, fully remote position
- Standard business hours with computer-based work
- Must have reliable high-speed internet (cable or fiber) of at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Oversee the daily operations of the Stop Loss department, including workflow management, staffing, systems, procedures, and reporting
- Monitor all stop loss claim filings (specific and aggregate) and ensure reimbursements and advance funding are accurate and timely
- Track stop loss claim filings, reimbursements, and cash advances to keep the department running efficiently and in line with audit/quality metrics
- Work closely with the Director, Stop Loss to set expectations, business goals, and performance standards
- Identify process gaps, streamline workflows, and implement policies and procedures that align with corporate strategy
- Collaborate with cross-functional teams to meet business objectives and resolve claim or process issues
- Perform weekly audits of specific claims, coordinating claim reprocessing and adjustments as needed
- Lead filing of aggregate claims and secure reimbursements
- Handle mid-year takeover stop loss reporting and related data needs
- Manage, coach, and develop direct reports, including one-on-ones, performance reviews, goal setting, and growth planning
- Clearly communicate expectations and provide team members with training, resources, and feedback to succeed
- Support special projects and other duties as assigned
What You Need
- Bachelor’s degree or equivalent relevant work experience
- At least 5 years of stop loss experience, either at a TPA or stop loss carrier
- At least 3 years in a supervisory or people-leadership role with proven leadership results
- Group health insurance/benefits background preferred
- Strong understanding of stop loss claim filings, reimbursements, and related operations
- Intermediate skills in Microsoft Word, Excel, and PowerPoint
- Excellent written and verbal communication skills
- Ability to troubleshoot daily operational issues and make timely decisions
- Strong organizational skills, attention to detail, and comfort working in a fast-paced environment
Benefits
- Salary typically in the 70,000 to 75,000 dollars per year range, depending on experience
- Medical, dental, and vision insurance
- Life and disability coverage
- Generous paid time off
- 401(k) with company match
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support remote work
- Remote-friendly culture with opportunities for growth and impact
Step into a leadership role where your stop loss expertise and people skills can directly shape outcomes for clients and members.
Happy Hunting,
~Two Chicks…