Director of Stop Loss

About Lucent Health

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.

Company Culture

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.

Honest

• Transparent Communication: be open and clear in all interactions without withholding crucial information
• Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
• Truthfulness: provide honest feedback and report any issues or challenges as they arise
• Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior

Ethical

• Fair Decision Making: ensure all actions and decisions respect company policies and values
• Accountability: own up to mistakes and take responsibility for rectifying them
• Respect: treat colleagues, clients and partners with fairness and dignity
• Confidentiality: safeguard sensitive information and avoid conflicts of interest

Hardworking

• Consistency: meet or exceed deadlines, maintaining high productivity levels
• Proactiveness: take initiative to tackle challenges without waiting to be asked
• Willingness: voluntarily offer to assist in additional projects or tasks when needed
• Adaptability: work efficiently under pressure or in changing environments

Summary:

We are seeking an experienced and strategic Director of Stop Loss to lead our stop loss insurance program within our self-funding division. This role will be responsible for developing and implementing stop loss strategies, managing relationships with insurance carriers, and ensuring compliance with regulatory requirements. The ideal candidate will have a strong background in stop loss insurance, underwriting, and self-funding practices.

Responsibilities:

• Strategic Leadership: Develop and execute the overall stop loss strategy in alignment with the company's objectives and market trends.
• Carrier Relations: Build and maintain strong relationships with stop loss insurance carriers to negotiate favorable terms and pricing.
• Risk Management: Analyze claims data to assess risk exposure and determine appropriate stop loss coverage levels for clients.
• Compliance Oversight: Ensure all stop loss programs comply with federal and state regulations, as well as industry standards.
• Client Consultation: Work closely with clients to educate them on stop loss options and tailor solutions that meet their specific needs.
• Team Management: Lead and mentor a team of professionals in the stop loss division, fostering a culture of collaboration and continuous improvement.
• Market Analysis: Stay informed about industry trends, competitive landscape, and regulatory changes affecting stop loss insurance.
• Performance Metrics: Establish and monitor key performance indicators (KPIs) to evaluate the effectiveness of stop loss programs and identify areas for improvement.

Qualifications:

• Bachelor's degree in Finance, Business Administration, or a related field; advanced degree preferred.
• Minimum of 5 years of experience in stop loss insurance, underwriting, or self-funding TPA operations.
• Strong knowledge of healthcare claims processing, risk management principles, and insurance regulations.
• Excellent negotiation and communication skills, with the ability to build relationships with clients and carriers.
• Proven leadership experience with the ability to motivate and manage a diverse team.
• Analytical mindset with strong problem-solving skills and attention to detail.
• Proficient in relevant software and tools, including data analysis and reporting tools.

Equal Employment Opportunity Policy Statement

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.