Senior Manager, Health Claims

Job Summary

Leading a dynamic claims unit, the full-time Senior Manager, Health Claims will oversee complex claims operations, manage a high-performing team, and collaborate with key partners to enhance customer service in a remote work environment.

Key responsibilities

• Direct the evaluation, investigation, negotiation, and settlement of complex claims, balancing policyholder interests with company objectives
• Supervise, mentor, and develop a talented claims team, managing work assignments and performance
• Monitor workflow and implement efficiencies to ensure prompt and accurate claims processing

Required qualifications

• 5+ years of medical stop loss insurance or health insurance claims experience required, with previous management experience preferred
• Proven leadership skills and deep industry expertise
• In-depth knowledge of claims practices, state and federal laws
• Experience in stakeholder management and customer-facing roles
• Proficiency with claims management systems and Sun Life products