At least 2 years experience and the following.
Stop loss Medical/consultant experience.
- Must have strong knowledge of all life, disability, health, and dental areas (both financial and benefits) for multiple insurance companies or TPA vendors.
Contact once you have applied:
Matt Duckworth - 6463986901
Matt.duckworth@oliverjames.com
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES
- Provide strategic planning and consulting advice to clients as related to Stop Loss Coverage
- Collect, review and prepare data to issue to market for quotes into the stop loss program(s)
- Work with teams to educate and explain process and coverage options
- Underwriting analysis of prospective entrants into program
- Assist with the implementation process with teams, TPA's and stop loss carriers
- Assist in the review of all agreements and/or documents related to client's stop loss coverage including policy and ASO agreement
- Manage ongoing case and experience data to help recommend implement appropriate case management and cost recovery programs.
- Review of Program(s) experience and provide executive summary of strength of program, loss ratios and recommendations to correct and/or work with carrier to resolve.
- Track program premium and commissions and work with Client Service Team or Broker to help resolve any client deficiencies.
- Meet with teams alone or in conjunction with Team or Company Leadership to review monthly a) large claims, b) abnormal utilization results, c) managed care and ongoing case management opportunities.
- Assist in working with carriers to deliver monthly reporting
- Assist with client/carrier issue resolution including but not limited to gray claims resolution.
- Review all agreements and/or documents for accuracy.
- Coordinate workflow with Associate Account Executives and/or Account Executive.
- Participate in monthly LDBC meetings.
- Participate in annual plan/business planning process.
- Ability to supervise and interview potential candidates for team employment.
- Ensure prompt payment of all commission and fee revenue for client work.
- Other responsibilities as required.
- Bachelor's Degree in business or related field with heavy emphasis in marketing and finance, or equivalent education and experience.
- Six years insurance industry experience.
- Must have strong knowledge of all life, disability, health, and dental areas (both financial and benefits) for multiple insurance companies or TPA vendors.
- Must be knowledgeable on compliance requirements and be current with state and federal legislation in this area.
- Excellent computer skills required with strong knowledge of software packages.
- Must have strong knowledge of vendor and competitors strengths and weakness.
- Must have excellent claims resolution expertise.
- Current required licenses or ability to immediately obtain.
- Excellent organizational and communication skills.
- Must be available for travel and willing to accept responsibility for client/vendor entertainment.
- Legal right to work in the United States.
