Senior Manager, Stop Loss Filling

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company. The Sr. Manager of Stop-Loss Operations is responsible for building and leading the stop-loss function that underpins Point C 's self-funded health plan business, ensuring accuracy, compliance, and consistency across a growing and increasingly complex book of business. This role serves as the operational backbone for stop-loss, acting as a trusted expert and change agent who unifies teams, systems, and processes inherited through growth and acquisition. The Sr. Manager oversees all aspects of stop-loss operations, from policy setup and filings through renewals and claims reimbursement, ensuring zero-error execution and a seamless experience for Account Management and clients alike. Job Responsibilities End-to-end leadership of the Stop-Loss Operations function, including policy setup, filing accuracy, laser and disclosure management, renewals, and claims reimbursement submissions. Integration of multiple stop-loss sub-teams — including those inherited through acquisition — that currently operate on different legacy platforms, workflows, and quality standards, into a single, consistent operating model. Design and enforcement of controls that drive the team toward zero processing errors and full compliance with carrier, regulatory, and contractual requirements. Development of standardized SOPs, quality-audit routines, and error-tracking mechanisms, with clear root-cause and corrective-ac