Senior Manager, Stop Loss & Health Claims
$68.2k - $102.3kThe Mississippi Bar
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: 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. 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: 30/08/2026 #J-18808-Ljbffr The Mississippi Bar
- ...that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK. The Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit, overseeing complex claims operations, guiding a high-performing staff, and partnering...SeniorClaimsWork at office
$240k - $270k
...Senior Account Executive - Healthcare Practice Denver/Coloradopreferred... ...provider organizations — health plans, multi-site clinics... ...), Revenue Cycle Management orchestration (denial management, claim status visibility, AR... ...learns from every loss. Use our SOW templates and...SeniorClaimsImmediate startRemote workFlexible hours$72.5k - $108.8k
...dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare... ...office at least 2 days per week. The Senior Case Manager I, LTD conducts the... ...management of long-term disability claims. The Senior Case Manager I, LTD acts...SeniorClaimsContract workWork experience placementWork at officeLocal areaFlexible hours2 days per week$60k
Progressive is looking for a dedicated claims specialist to efficiently resolve large-loss injury claims over $60k. You will investigate complex claims, collaborating... ...at least six years of relevant experience, you will manage claims and contribute to a supportive team culture....SeniorClaimsWork at office$71k - $104k
...workers' compensation and claims support? Join ESIS, a leader in risk management and insurance services,... ...are seeking a skilled Senior Claims Representative to... ...including releases, proofs of loss, or compensation... ...accident and supplemental health insurance, reinsurance,...SeniorClaimsFull timeTemporary workWork at officeLocal area- Consonus Pharmacy is seeking a Pharmacy Claims Manager to oversee claims processing, adjudication, third‑party billing, and reimbursement optimization for long‑term care environments. The role leads a team to ensure timely submissions, resolve claim exceptions, and maintain...SeniorClaims
- PacificSource is seeking a Senior Fraud, Waste and Abuse Investigator in Portland, OR to lead complex FWA investigations... ..., and document onsite and desktop investigations of health care claims, and present findings to management. The role requires 5+ years in healthcare fraud...SeniorClaims
$105k - $115k
...Description:Job Summary:The Sr. Project Manager of Client Services serves as a key leader... ...professional services, consulting, client services, claims administration, litigation support, or... ...status, sexual and other reproductive health decisions, marital status, age, national...SeniorClaimsFull timeLocal areaWork visa- Kaiser Permanente in Portland, OR is seeking an experienced coder for a documentation review and coding position focused on accurate claim submission and regulatory compliance. The role requires two years in healthcare, with at least one year of professional coding...SeniorClaims
$68.2k - $102.3k
...services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more... .... The opportunity The Health and Risk Solutions Senior Claim Analyst serves as the highest level of technical...SeniorClaimsContract workWork at officeLocal areaFlexible hours- ...empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with...SeniorClaimsLocal areaRemote 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
- ...delivering tailored insurance solutions? As a Private Client Service Manager at Gallagher, you’ll be the trusted advisor for High Net Worth... ...: Bachelor's degree with 5+ years client service and/or claims management experience -OR- High School degree/GED with 10+ years...SeniorClaimsLocal area
$137.7k - $229.5k
...speed-to-value. Work you'll doAs an Health and Welfare Senior Consultant in Strategy, Growth, and Transformation... ...projections and support health plan management, including financial reporting,... ...guarantees, and renewals.Analyze claims utilization data and assess health...SeniorClaimsLocal area- ...in the K-12 Education market, and as a member of LAN’s Program Management (Owner’s representative) team, the successful candidate will act... ...with Owner standards Coordinate dispute resolution and claims avoidance Manage the Change Order tracking system Review applications...SeniorClaimsFor contractorsLocal areaImmediate startNight shiftEarly shift
$100k
...states, is the largest home health and hospice company in... ...RN and PT Case Managers; monitor action screens,... ...and minimize outstanding claims. Approve schedules, payroll... ...time by responding with "STOP". Let Better Growth Come To You! Seniority level Mid‑Senior level...ClaimsFull timeWork at officeLocal areaFlexible hours$128k - $252.5k
...healthcare ecosystem. As an Actuarial Senior Consultant, you will apply... ...spanning the entire health care landscape and product types... ..., providers, pharmacy benefit managers, and federal and state government... ...network changes, or other detailed claims analytics Review Medicare...SeniorClaimsWork at officeLocal areaVisa sponsorship$170k - $200k
...rare diseases, and reproductive health. We believe that by providing... ...redefine the way medicine is managed for patients and clinicians alike... .... Summary Of Position The Senior Genomics Sales Director is responsible... ...for the overall profit and loss of the region. Key Job...SeniorContract workImmediate startFlexible hoursShift work$137.5k - $167.5k
...are we?Smarsh empowers its customers to manage risk and unleash intelligence in their digital... ...a position where they can act) as the senior Salesforce partner to: Sales / SalesOps,... ...knowledge sharing.Establish metrics for platform health, not just delivery velocityWhat Success...SeniorFull timeTemporary workFixed term contractLocal area$138.1k - $315.6k
...transformation, and commercial excellence. This senior role within our Consulting practice will... ...strategy is a must have Effectively manage and motivate client engagement teams with... ...e.g. pricing databases, prescription and claims databases, etc.) Experience with...SeniorClaimsSummer holidayFlexible hours- ...Responsible for the overall management and delivery of treasury, accounting... ...& targetsKey Relationships:Senior Vice President Finance and... ..., Work-Labor Contracts, Claim Management, Liability, Warranty... ...progressive medical, including HSA (Health Savings Account) with...SeniorClaimsFull timeTemporary workWork at officeRemote workMonday to ThursdayFlexible hours
$85k - $125k
...Zurich Canada is currently looking for a Senior Underwriter, Management Liability on our Financial Lines team... ...with internal partners such as claims, risk engineering and other underwriting... ...well-being and offer a comprehensive health/benefits plan with varying levels of...SeniorClaimsTemporary workApprenticeshipWork at officeLocal areaWorldwide3 days per week$126.08k - $189.12k
Adventist Health Portland seeks a HR Manager to lead strategic HR operations. This role involves advising leadership on talent management and overseeing compliance-related matters. The ideal candidate has extensive HR experience, especially in healthcare, and will actively...SeniorFull time- Shields Health Solutions seeks a Manager of Clinical Services to lead ambulatory and centralized pharmacy programs in partnership with a health system partner. You will supervise a team of specialty clinical pharmacists, drive CPAs, and champion high-quality patient care...SeniorRemote job
- Comagine Health is seeking an experienced Senior Improvement Advisor based in Utah to help healthcare organizations improve care delivery, strengthen... ...provide training, technical assistance, and program management support for health system improvement initiatives across...Senior
- Mortenson is seeking a Senior Project Manager I and II to lead large projects while ensuring quality, safety, and mentoring team members. Candidates will manage financial health, schedule, and customer relationships, needing strong communication and flexibility. Offering...Senior
$67k - $126k
...00.00 - $126000.00 Job Category: Claims Description Are you looking for... ...offers an exciting opening for a Senior Workers Compensation Claims Specialist... .../compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property...SeniorClaimsFull timeWork experience placementLocal areaRemote work- Sinceri Senior Living is seeking a Health Services Specialist to oversee health services operations in Portland, Oregon. This role requires a Registered Nurse with management experience and entails significant travel of 90% - 95%. Join a company recognized as a Great Place...SeniorInterim role
$83.97k - $143.94k
...States of AmericaSalary: $83,966 - $143,942Company: Siemens Senior Project Manager - Fire/Life Safety Systems Job ID 517059 Posted... ...does every day?You’ll Benefit FromSiemens offers a variety of health and wellness benefits to our employees. Details regarding our...SeniorPermanent employmentFull timeFor subcontractorWork at officeLocal areaImmediate start- ...Insurance seeks a dedicated Workers Compensation Claims Specialist to join the West Region Claims Team.... ...casualty claims with bodily injury or property loss. Depending on experience, roles include Specialist II or Senior Specialist I/II. Candidates must reside within 5...SeniorClaims
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Manager, Stop Loss & Health Claims. Be the first to apply!
- psychiatry medical director Portland, OR
- remote medical coding supervisor Portland, OR
- clinical data manager remote Portland, OR
- healthcare supervisor Portland, OR
- mental health clinical supervisor Portland, OR
- clinical program director Portland, OR
- associate director clinical operations Portland, OR
- medical coding manager Portland, OR
- clinical operations director Portland, OR
- healthcare program manager Portland, OR



