Owns stop-loss risk evaluation and proposal management for self-funded healthcare cases. Reviews claims, census, and plan design; prepares RFPs and submissions; manages carrier relationships; compares quotes; advises sales on case strategy; and builds repeatable quoting tools and processes. Partners with sales, brokers, finance, and actuarial teams while coaching junior sales support staff.
Company Overview:
Our company is a start-up that specializes in episodes of care benefit plans. We have a deep expertise in episode pricing and analytics and our goal is to bring transparency and efficiency to the healthcare market. Our company is committed to providing high-quality, affordable healthcare to our customers.
Role Description
The Senior Manager, Stop-Loss Risk and Proposals owns the front end of our sales process for self-funded cases. You will evaluate the risk on each case, prepare it for our stop-loss carrier underwriting partners, and manage the proposal through to a quote. This is not a carrier underwriting seat. It is a role for someone who has underwritten stop-loss, knows how underwriters will look at a case before they see it, and wants to use that knowledge on the business side to help our sales team bring better-prepared cases to market and win them.
Responsibilities
Risk Evaluation and Management
- Review incoming cases and assess the risk before they go to underwriting, including claims experience, census, and plan design.
- Advise sales leadership on how a case is likely to be viewed and priced by stop-loss carriers, and on which cases to pursue.
RFP and Proposal Management
- Own the RFP and proposal process for self-funded stop-loss cases, from intake through submission, quote, and follow-up.
- Check every submission and proposal for accuracy and completeness before it goes out.
- Gather and compare carrier quotes and recommend the best placement for each case.
Carrier and Underwriter Relationships
- Work as the day-to-day contact for our stop-loss carrier underwriting partners.
- Stay current on how each carrier evaluates specific and aggregate stop-loss risk, and on pricing and competitive trends in the self-funded market.
Sales Enablement and Team
- Partner with sales, brokers, and consultants on case strategy and quotes.
- Work across sales, finance, and actuarial partners so that pricing, risk, and proposals stay aligned.
- Build the tools and repeatable processes behind submissions and quoting, and coach junior sales support staff.
Qualifications
- Describe the experience and attributes of the ideal candidate
- Stop-loss underwriting experience, ideally at a stop-loss carrier, reinsurer, or managing general underwriter and/or Business-side experience supporting a sales team or broker channel through the RFP, proposal, and quoting process.
- 7+ years of combined experience in self-funded group health stop-loss on either the carrier or business side.
- Working knowledge of specific and aggregate stop-loss, including how cases are underwritten and priced.
- Bachelor’s degree or equivalent experience.
Benefits
- Health: Medical, dental, and vision insurance
- Retirement: 401(k) with company match
- Paid leave: Vacation, Sick, and company holidays
- Ancillary: Company-paid life and disability insurance
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