Stop Loss Operations Manager, Remote

CVS Health • Saint Paul, MN • 1h ago

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Join Meritain, a subsidiary of CVS Health as the Manager of Stop Loss/Reinsurance Operations. In this high impact role, you will lead a team of about 12-15 colleagues who are responsible for the filing of Stop Loss claims to partner Managing General Underwriter (MGU) and Stop Loss Carriers, follow up, reconciliation and posting of Stop Loss reimbursements. As 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.

We are seeking an operational innovator who thrives in a high-energy, fast-paced, and high-growth environment. The ideal candidate will demonstrate the ability to seamlessly transition between strategic initiatives and tactical execution, while consistently delivering results. Strong verbal and written communication skills are essential, along with a proven capacity to influence and collaborate across all levels of the organization.

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

Minimum 5 years operations (claims, eligibility, plan setup, implementation) or related field; stop loss/reinsurance experience highly preferred

Progressive leadership experience managing projects and/or teams

Health Care or Insurance setting

Preferred Qualifications

Prior experience managing large teams

Medical Claims Operations exposure

Education

bachelor's degree preferred/specialized training/relevant professional qualification.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Similar Jobs

Fusion COE Operations + Program Manager

Oracle • Saint Paul, MN • 1h ago

Management & Administrative

Job Description It is an exciting time to be a part of the Oracle Cloud Development organization. As we continue to rapidly introduce new products and enhancements, we are focused on delivering AI capabilities that will...

1h ago

Go to Apply

Data Security Posture, Access Governance, and Lifecycle Management Lead

U.S. Bank • Hopkins, MN • 3h ago

Management & Administrative

At U.S. Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We believe it tak...

3h ago

Go to Apply

Growth & Lifecycle Marketing Manager

Datavant • Saint Paul, MN • 6h ago

Management & Administrative

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is power...

6h ago

Go to Apply

Senior Product Marketing Manager

Datavant • Saint Paul, MN • 6h ago

Management & Administrative

6h ago

Go to Apply

Administrative Receptionist

Presbyterian Homes and Services • Andover, MN • 6h ago

Management & Administrative

Overview Presbyterian Homes & Services, The Farmstead, is seeking a Full Time Administrative Receptionist for its team. The Receptionist reports to the Resident Services Director or dedicated Quality Service Team mem...

6h ago

Go to Apply

Account Manager II - RE-Expansion

Lumen • Saint Paul, MN • 6h ago

Management & Administrative

About Lumen Lumen connects the world. We are igniting business growth by connecting people, data and applications - quickly, securely, and effortlessly. Together, we are building a culture and company from the people up...

6h ago

Go to Apply

Account Manager (Positioning)

RDO Equipment Co • Maple Grove, MN • 6h ago

Management & Administrative

Description This individual will develop long term partnerships with our customers to build win/win solutions within an assigned territory while promoting all aspects of RDO Field Technology in a professional manner. The...

6h ago

Go to Apply

Advisory Manager - Strategy and Growth - Payer Consulting - Remote

UnitedHealth Group • Eden Prairie, MN • 6h ago

Management & Administrative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the ca...

6h ago

Go to Apply

Advisory Consultant - Payer Strategy - Remote

UnitedHealth Group • Eden Prairie, MN • 6h ago

Management & Administrative

6h ago

Go to Apply

CTIO - Technical Product Manager

PwC • Minneapolis, MN • 16h ago

Management & Administrative

Specialty/Competency: IFS - Information Technology (IT) Industry/Sector: Not Applicable Time Type: Full time Travel Requirements: Up to 40% At PwC, our people in software and product innovation focus on developing cuttin...

16h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.