ASO & Alt Product Mgmt, Professional, Stop Loss Account Risk Analyst Team Lead

Headquarters Office, 625 State Street, Schenectady, New York, United States of America Req #620
Friday, November 13, 2020
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.



JOB SUMMARY
Responsible for end to end stop loss policy administration for MVP’s ASO and Level Funding business.  This includes but is not limited to specific claimant identification, completion of notification forms, and claims filing to ensure MVP meets its contractual and fiduciary responsibilities. Responsible for timely submission of all required reporting such as group specific claimant, eligibility questionnaires, and monthly aggregate reports.
Acting as liaison between MVP, its brokers, Stop Loss Carrier, and Vendor partners, the Stop Loss Analyst will solicit and negotiate stop loss proposals from MVP’s stop loss carrier partners.  Working in collaboration with the MVP Sales and Account Management Teams the Stop Loss Analyst will present stop loss proposals and renewals to MVP’s clients and/or brokers. 

PRINCIPAL ACTIVITIES

ESSENTIAL FUNCTIONS:


1. Develop, implement, and maintain a process for identifying potential specific claimants within each ASO and Level Funded clients’ utilization data. 

2. Manage specific and aggregate claim submission process, acting as liaison between MVP and its stop loss carrier partners.

3. Collaborate with key areas across the MVP organization to ensure potential specific claimants are identified and monitored timely and accurately.

4.  Collaborate with New Sales Executives, Sales Account Managers and/or Client Manager(s) for the management of new stop loss quote requests as well as renewal quote requests.  Act as subject matter expert for the purpose of stop loss policy and premium quote review. 

5. Proactively cultivate strategic relationships with MVP’s stop loss carrier partners.

6.  Maintain and update all data sources for the purpose of monthly data analysis. Generates timely and accurate financial data for monthly report submissions.

7.  Proactively reviews weekly reports to identify potential high cost claimants.  Provides stop loss carrier with necessary information required for claim reimbursement consideration.


8. Participate in internal workgroups and task force(s) as needed to successfully implement stop loss administration solutions.  

9. Act as back-up to other Stop Loss Analysts as needed.  

10. Participate actively in team and department meetings on stop loss administration process, new product implementation planning as it may relate to stop loss management.

11. Ensure stop loss industry knowledge is kept current at all times, bringing forward ideas and recommendations to ensure MVP has competitive position in the market place.

12. Other projects as assigned by the Leader, Alternative Funding and Stop Loss Administration.

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Sales
  • Pay Type Salary
  • Headquarters Office, 625 State Street, Schenectady, New York, United States of America