Senior Manager, Stop Loss & Health Claims
$68.2k - $102.3kSun Life
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.
When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.
The opportunity: The Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit. In this critical role, you'll oversee complex claims operations, manage a high-performing team, and collaborate with key partners to drive our continued growth and excellence in customer service.
How you will contribute:
Lead Claims Operations : Direct the evaluation, investigation, negotiation, and settlement of complex claims, ensuring optimal balance between policyholder interests and company objectives.
Manage and Develop Staff: Supervise, mentor, and grow a talented claims team, overseeing work assignments, performance management, and professional development.
Optimize Processes: Monitor workflow, implement efficiencies, and ensure prompt, accurate claims processing to enhance operational effectiveness.
Collaborate with Partners: Work closely with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel to maintain Sun Life's strong reputation and drive business growth.
What you will bring with you :
Ability to work with a diverse range of people
5+ years of medical stop loss insurance or health insurance claims experience required, previous management/leadership experience preferred
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
Salary:
$68,200-$102,300
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We’re proud to be recognized in our communities as a top employer. Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email View email address on click.appcast.io to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Category:
Claims - Health & Dental Posting End Date:
30/10/2026
Vacancy posted 8 hours ago
Similar jobs that could be interesting for youBased on the Senior Manager, Stop Loss & Health Claims in Nashville, TN vacancy
$18.5 - $35.29 per hour
...We’re building a world of health around every individual — shaping a more connected,... ...community at a time. Position Summary The Stop Loss Claims Analyst supports stop loss claim filing... ..., eligibility, finance, client management, and provider and broker relations. It...ClaimsHourly payFull timeWork at officeLocal area- ...Job Description About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused... ...Summary The Entry-Level Stop Loss Support Specialist is responsible... ...issues or missing information to senior team members Respond to basic...ClaimsWork at office
$104.37k - $156.55k
...auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate... ...are not available for this position. The Senior Engagement Manager serves as a strategic partner to our clients...SeniorClaimsFull timeImmediate startRemote workVisa sponsorshipShift work- ...About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven... ...decision makers Supports Senior Account Executive staff with New... ...Assists with end of contract Stop Loss review Assists with special...ClaimsContract work
- ...each week. Position Summary: The Senior Manager, Operational Excellence leads... ...final mile route density and stops-per-hour, dock and cross-dock labor productivity, claims and OS&D reduction, and... ...therapists through FirstStop Health available first day of employment...SeniorClaimsHourly payFor contractorsWork at officeRemote workWorldwide1 day per week
$177.91k - $230.23k
...to fight against the world’s biggest health challenges, and our mission requires... ...illnesses worldwide. The Senior Field Reimbursement Manager – HIV Prevention is a highly specialized... ...prior authorization, medical exception, claims, acquisition, specialty pharmacy, and...SeniorClaimsFull timeFor contractorsWork at officeLocal areaRemote workWorldwide- ...& Insurance RN Field Case Manager We are growing all across the... ...making an impact on the health and lives of others, and a remote... ...the world's leading risk and claims administration partner, which... ...solutions in claims administration, loss adjusting, benefits...ClaimsFull timeWork at officeRemote workWork from homeRelocation packageFlexible hours
- ...Senior Marketing Manager Optura is healthcare's AI orchestration platform. We help healthcare organizations... ..., including: Comprehensive health, dental, and vision insurance... ...job offer or suspicious communication claiming to be from Optura.ai, please exercise...SeniorClaimsRemote work
- ...Senior Vice President, Benefits About the Company Global risk management firm helping clients navigate complex risks... ...risk analytics claims advocacy bermuda... ...years' of experience in health and benefits or a... ...in the medical stop loss, self-funding, or benefits...SeniorClaims
- ...Path to Good HealthUpperline Health is the nation's largest provider... ...value-based care.About the Senior Counsel, Healthcare... ...-Kickback Statute, the False Claims Act, state fraud and abuse laws... ...cardiology, vascular, chronic care management) and assist in implementing new...SeniorClaimsFull timeTemporary workImmediate start
$90k - $115k
...Description Job Description Title: Commercial Lines Account Manager Location: Nashville, TN Salary: $90,000 - 115,000 (... ...insurance program for possible changes facilitating resolution to claims coordinating the delivery of value added services....SeniorClaims$107.9k - $172.64k
...Job Description The Senior Technical Project/Program Manager leads complex, technology-driven projects and initiatives... ...into project or initiative health. The PM serves as the primary point... ...organizations, and internet sites claiming to represent Blue Cross and Blue Shield...SeniorClaimsWork at officeLocal areaRemote workFlexible hours2 days per week$175.42k - $263.1k
## Senior Counsel, LitigationApply: Fully Remote: Nashville, Tennessee... ...leading nonprofit behavioral health systems with thousands of... ...The Senior Counsel, Litigation manages the organization's litigation... ...executive leadership.• Evaluate claims and recommend resolution strategies...SeniorClaimsFull timeWork at officeRemote workFlexible hoursShift workAfternoon shift- ...Job Description Job Description 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...ClaimsContract workLocal areaNight shift
$46.99k - $112.2k
...We're building a world of health around every individual - shaping a more connected, convenient... ...at a time. Position Summary The Senior Investigator, Aetna Special Investigations... ...integrity to prevent payment of aberrant claims submitted to the Medicaid lines of business...SeniorClaimsHourly payFull timeTemporary workWork at officeLocal area$144k - $180k
...nonprofit dedicated to achieving health equity. With more than 40... ...address the leading diseases that claim children’s lives worldwide:... .... PATH is seeking a Senior Statistician who is an experienced... ...of Statistics and Data Management, under the leadership of the...SeniorClaimsInterim roleRemote workWorldwide- ...Interim Senior Director, Lab Services About the Company A health system needing systemwide laboratory leadership and operational improvement. Industry Hospital & Health Care Type Privately Held About the Role The Company is seeking an Interim Senior...SeniorInterim roleFlexible hours
$20 - $36 per hour
...Optum Insight is improving the flow of health data and information to create a more connected... ...reduce costs while improving risk management, quality and revenue growth. Ready to help... ...% of your day can be on phones) Provide claims expertise support by reviewing,...SeniorClaimsHourly payMinimum wageFull timeContract workWork experience placementLocal areaMonday to FridayShift work$79.3k
...Company : Highmark Health Job Description : JOB SUMMARY CANDIDATE MUST BE US... ...costs of care, efficiently and effectively managing projects to successful completion.... ...software, systems, tools and processes using claims, clinical, enrollment and provider data...SeniorClaimsFor contractorsWork at officeLocal areaShift work$120k - $150k
...Owner's Representative (Senior Construction Project Manager)A Southeast regional real estate development firm works largely in the commercial/multi... ...BenefitsSalary Range DOE $120-150,000 / year.Comprehensive Health Insurance Benefit Plans Provided at NO COST to employee3...SeniorFull timeContract workFor contractorsWork at officeRemote work$86.4k
...Company : Highmark Health Job Description : JOB SUMMARY This job promotes... ...Nursing, Informatics, Health Information Management, Information Systems or related field, or... ...~1+ years of working with healthcare claims data ~ Experience supporting academic...SeniorClaimsFor contractorsWork at officeLocal area$125.24k - $187.86k
...auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments... ...support are not available for this position. As a Senior Data Engineer on the Data Platform team, you will...SeniorClaimsPermanent employmentFull timeRemote workVisa sponsorship$134.6k - $230.8k
...our team will directly improve health outcomes by connecting people... ...The Chief of Staff / Program Manager serves as a trusted advisor and... ...without direct authority across senior stakeholdersPreferred... ...network management, pricing, and/or claims platformsFamiliarity with go-to...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work- ...ability to anticipate needs, communicate clearly, and proactively manage the daily schedule helps ensure an efficient, high-quality... ...payments into EMR; allocate balances appropriately and support claim preparation and submission. Run reports and review accounts to...ClaimsFull timeWork at office
$54.1k - $155.54k
...We're building a world of health around every individual - shaping a more connected, convenient... ...Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/... ...focus to benefit overall claim management. Using a holistic approach,...ClaimsHourly payFull timeLocal areaRemote workWork from homeFlexible hours$67.9k - $199.14k
...We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience... ...leader to drive successful results within Service Operations. The Senior Manager, Operations will lead the day-to-day operations of a non-...SeniorHourly payFull timeTemporary workWork experience placementLocal area$72.2k - $120.4k
...accessible and affordable. Here, we focus on the health, happiness, and well-being of you and... ...you. The CoverMyMeds Field Reimbursement Manager (FRM) is responsible for managing an... ...Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating...ClaimsWork at officeRemote workWork from home- ...Job Description Job Description 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...ClaimsRemote workFlexible hours
- ...Officer\nWho We Are:\nAt Herself Health, we're on a mission to help... ...and bone health to weight management, preventive care, and mental,... ...Official Guidelines, the False Claims Act, HIPAA, and Herself... ...primary care — particularly senior-focused or Medicare Advantage...ClaimsFull timeContract workRemote work
$80.4k - $293.8k
...stream from quoting through claims — will capture... ...looking for consulting managers who understand the domain... ...financial models grounded in loss ratio mechanics,... ...benefits, voluntary benefits, health insurance, or an... ..., supplemental health, stop-loss ~ Broker channel...ClaimsFull timeLive inWork at officeLocal areaShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Manager, Stop Loss & Health Claims. Be the first to apply!
Related searches
- health economics manager Nashville, TN
- remote medical coding supervisor Nashville, TN
- occupational health manager Nashville, TN
- director of health and wellness Nashville, TN
- medical director neurology Nashville, TN
- public health director Nashville, TN
- clinical research manager remote Nashville, TN
- director sr. director clinical operations Nashville, TN
- medical director remote Nashville, TN
- urgent care medical director Nashville, TN



