Senior Manager, Stop Loss Filling

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs.

Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point

B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

• End-to-end leadership of the Stop-Loss Operations function, including policy setup, filing accuracy, laser and disclosure management, renewals, and claims reimbursement submissions.
• Integration of multiple stop-loss sub-teams — including those inherited through acquisition — that currently operate on different legacy platforms, workflows, and quality standards, into a single, consistent operating model.
• Design and enforcement of controls that drive the team toward zero processing errors and full compliance with carrier, regulatory, and contractual requirements.
• Development of standardized SOPs, quality-audit routines, and error-tracking mechanisms, with clear root-cause and corrective-action discipline.
• Direct oversight and coaching of stop-loss team leads and staff, including performance management, capacity planning, and career development.
• Serving as the primary operational partner to Account Management, Sales, and Client Services on all stop-loss matters — filings, coverage questions, escalations, and renewal readiness — protecting the client experience even when the underlying issue is internal.
• Partnership with carriers and MGUs on policy terms, filing requirements, timeliness standards, and issue resolution.
• Building and reporting KPIs and SLAs (filing timeliness, error rates, reimbursement turnaround, audit results) to executive leadership.
• Supporting platform migration work (including Qic Link-to-VBA transition) as it relates to stop-loss data, workflows, and system configuration.
• Acting as a change agent across the broader Operations organization — identifying process gaps beyond stop-loss and championing a “systems over silos” approach to how teams work together.

• 7+ years of progressive stop-loss experience at a TPA, carrier, MGU, or reinsurer, including direct management of a stop-loss operations team.
• Established rapport and working relationships with stop-loss carriers and MGUs, with a track record of managing day-to-day carrier communication, filings, and escalations, and maintaining credibility through renewals and disputes.
• Demonstrated success integrating or consolidating teams that operated on different legacy systems, workflows, or standards — you can point to a specific before-and-after.
• Deep working knowledge of stop-loss policy mechanics: specific and aggregate coverage, lasers, disclosure requirements, run-in/run-out, and claims reimbursement processes.
• A track record of building or overhauling processes to drive error rates toward zero and sustain full compliance — not just identifying problems, but fixing them permanently.
• Strong cross-functional partnership skills, with the credibility and communication style to work closely with Account Management and other client-facing teams without becoming purely reactive to them.
• Comfort operating in a fast-moving, private-equity-backed environment undergoing platform migration and acquisition integration.
• Experience with Qic Link, VBA, or comparable TPA core administration platforms strongly preferred.
• Experience with Ringmaster or a comparable TPA stop-loss filing software strongly preferred.
• Excellent written and verbal communication skills, including the ability to translate operational detail into clear updates for executive leadership.

$80,000 — $90,000 USD

Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive…