Job Overview
Location
Indiana, USA
Job Type
Full-time
Category
Operations Manager
Date Posted
February 25, 2026
Full Job Description
đź“‹ Description
- • Centivo is on a mission to revolutionize healthcare affordability and quality for the backbone of our economy – workers and their employers. We are seeking a dedicated and experienced Stop Loss Supervisor to join our growing team and play a pivotal role in ensuring the seamless administration of stop loss policies for our self-funded clients.
- • In this critical role, you will operate under the expert guidance of the Stop Loss Manager, taking ownership of the end-to-end stop loss administration process. Your primary responsibility will be to meticulously oversee and ensure the accurate and timely completion of all stop loss-related activities, safeguarding our clients' interests and Centivo's contractual obligations.
- • This encompasses a wide range of essential tasks, including the precise identification of specific claimants, the diligent completion of notification forms, and the comprehensive reporting of high-cost claimants and clinical information to stop loss carriers. You will also be instrumental in managing claims filing to guarantee that Centivo consistently meets its contractual and administrative responsibilities, thereby reinforcing our reputation for reliability and excellence.
- • Your role will extend to fostering strong collaborative relationships with a diverse array of internal departments. This includes close partnership with Client Success, Implementation, Claims, Member Care, IT, Clinical, and Sales teams, ensuring a unified approach to stop loss management. Furthermore, you will engage with external Pharmacy Benefit Managers (PBMs) and other critical third-party administrators (TPAs) within the industry, as well as brokers, consultants, and various vendors.
- • As the primary point of contact for first-level issue resolution and reporting concerns, your ability to effectively communicate and problem-solve will be paramount. You will be the linchpin in gathering the necessary information to support the Stop Loss Management team in providing accurate and efficient policy management for Centivo’s valued clients.
- • A key aspect of your role will be to oversee the stop loss management team, ensuring they adhere to established end-to-end stop loss claim processes and procedures. Your leadership will drive the accurate and timely filing of all carrier requests, ultimately securing reimbursements on behalf of our clients.
- • You will also be a crucial contributor to the evolution of our stop loss systems, taking ownership of user acceptance testing (UAT) for system upgrades and enhancements. Your rigorous testing will ensure that existing functionality remains robust and that new capabilities effectively meet our operational requirements, contributing to a more efficient and effective administration process.
- • Collaboration is at the heart of this role. You will work cross-functionally with Stop Loss Coordinators and all key stakeholders to facilitate timely information exchange and decision-making, always prioritizing the best interests of our clients and the organization.
- • In partnership with the Stop Loss Manager, you will actively contribute to process optimization. This includes identifying and sourcing new tools, managing staffing needs by assessing requirements for new positions and developing comprehensive training programs, and collaborating with internal teams to address and resolve escalated issues.
- • A proactive approach to claimant identification is essential. You will maintain and refine a robust process for identifying potential specific claimants by analyzing client utilization data, working closely with other key departments to ensure timely monitoring and management of these cases.
- • You will manage the intricate processes for submitting specific and aggregate claims, serving as the primary liaison between Centivo and its stop loss carrier partners. This involves ensuring Non-Disclosure Agreements (NDAs) are in place with new carriers before any client data is shared, providing carriers with all necessary information for claim reimbursement consideration and appeal submissions, and proactively requesting necessary changes to stop-loss policies or client SPDs to ensure seamless coverage.
- • Your involvement in internal workgroups and task forces will be vital for the successful implementation of stop loss administration initiatives. You will also be responsible for analyzing stop-loss policies against quotes, applications, and plan documents to ensure absolute accuracy and agreement, preventing potential discrepancies.
- • Active participation in team and department meetings is expected, contributing to discussions on stop loss administration processes and client/product implementation planning. Furthermore, you will be tasked with staying abreast of the latest developments in stop loss industry knowledge, proactively bringing forward innovative ideas and recommendations to maintain Centivo's competitive edge in the marketplace.
- • A significant part of your role will involve training new hires, imparting essential workflows and processes, and developing and maintaining comprehensive documentation that outlines current state policies and procedures, ensuring consistency and knowledge transfer across the team.
- • Finally, you will undertake other miscellaneous projects, assignments, and duties as assigned by management, demonstrating your versatility and commitment to the team's success.
- • As a working supervisor, you will actively participate in the day-to-day tasks alongside your team, monitoring and managing assignments, and ensuring resource balancing. You will also play a key role in developing policies, processes, and procedures to continuously improve departmental services, defining staffing ratios, and clarifying roles and responsibilities. Leading the management of new functionality and workflows to enhance efficiency and automate manual processes, alongside ensuring effective knowledge transfer and training, will be central to your leadership.
🎯 Requirements
- • 5 years of experience in stop loss policy management and/or financial claims analytics, with a strong understanding of self-funded insurance.
- • 3 years of experience leading and delegating tasks to multiple direct reports, demonstrating strong team management and development skills.
- • Bachelor’s degree required.
- • Advanced knowledge of Microsoft Office Suite (Excel, PowerPoint, Word), with a proven ability to leverage these tools for data analysis and reporting.
- • Excellent oral and written communication skills, with the ability to present information clearly, persuasively, and to establish rapport with diverse audiences.
🏖️ Benefits
- • Competitive salary and comprehensive health benefits package.
- • Opportunity to work remotely, offering flexibility and work-life balance.
- • Be part of an innovative company with a mission to make healthcare more affordable and accessible.
- • Professional development and growth opportunities within a rapidly expanding organization.
- • Collaborative and supportive team environment.
Skills & Technologies
Go
Remote
Degree Required
About Centivo Inc.
Centivo is a health plan administrator that partners with self-insured employers to provide affordable healthcare benefits. It builds custom networks of high-value primary care providers and specialists, emphasizing coordinated care, transparent pricing, and payment innovations like prospective bundled payments. The platform offers members digital tools for provider search, cost estimates, and care navigation, while giving employers predictable costs and data analytics to improve population health outcomes.
