Clinical Patient Engagement Manager leading the development of clinical content for adherence and outcomes improvement with a focus on rare diseases at PANTHERx.
About the role
- Senior Manager leading health insurance claims operations at Sun Life, overseeing team management and complex claims processing. Collaborating with partners to enhance customer service and business growth.
Responsibilities
- Oversee complex claims operations
- Manage a high-performing team
- Direct the evaluation, investigation, negotiation, and settlement of complex claims
- Ensure optimal balance between policyholder interests and company objectives
- Supervise, mentor, and grow a talented claims team
- Monitor workflow and implement efficiencies
- Collaborate with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel
Requirements
- 5+ years of medical stop loss insurance or health insurance claims experience required
- Proven leadership skills and deep industry expertise
- Strong analytical and problem-solving abilities
- Experience in stakeholder management and customer-facing roles
- In-depth knowledge of claims practices, state and federal laws
- Excellent communication and negotiation skills
- Ability to analyze and communicate complex data and trends
- Proficiency with claims management systems and Sun Life products
Benefits
- Health insurance
- 401(k) employer match
- Paid family, parental and adoption leave
- Generous vacation and sick time
- Medical coverage
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
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