Director, Stop Loss Claims
About The Position
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. Director, Stop Loss Claims Responsible for our multi-site claims organization, providing strategic leadership and managing all activities across the entire Stop Loss claims lifecycle. This role focuses on improving efficiencies, enhancing client experience, and streamlining claims adjudication processes for our Stop Loss product line. This role requires a strategic thinker with extensive knowledge of Stop Loss claims, strong leadership skills, and project management expertise. Additionally, this position is responsible for maximum level of Client service which has a direct impact on meeting persistency targets. This role offers an opportunity to drive significant improvements in our claims operations while ensuring top-tier client service in the Stop Loss insurance sector.
Requirements
- Ability to work with a diverse range of people
- Bachelor's degree or equivalent experience
- 7+ years of Stop Loss and/or Medical claims and product knowledge
- 5+ years in a leadership role
- Extensive understanding of Stop Loss/Medical products, claims systems, and service impacts
- Experience overseeing a claims management function
- Strong leadership, coaching, and team-building skills
- Excellent communication and interpersonal abilities
- Proficiency in MS Office and claims-related software
- Experience in project management and process improvement methodologies
- Superior collaboration skills
- Demonstrates resilience by reacting positively to changes and maintains poise, focus and flexibility when encountering difficulties or obstacles
- Ability to interpret and communicate policy language effectively
Responsibilities
- Drive operational excellence by advancing claims processes and implementing automation
- Manage and optimize claims operations across multiple sites
- Monitor and manage inventory to meet defined metrics and OKR’s
- Collaborate effectively across multiple departments to achieve goals
- Identify opportunities and implement solutions for improved CX based on feedback and needs expressed by clients and brokers
- Cultivate best-in-class claims capabilities, strengthening Sun Life’s position as a market leader in Stop Loss Claims
- Identify and implement process improvements to enhance efficiency and reduce staffing
- Manage claims staff, including selection, training, and performance oversight
- Ensure compliance with internal audit requirements and regulatory standards
- Resolve escalated customer issues and maintain high levels of client service
- Lead projects to improve claims processing and customer experience
- Analyze claims trends and provide insights for product development and reporting
- Develop and implement strategies to meet quality and turnaround time goals
Benefits
- Generous vacation and sick time
- Market-leading paid family, parental and adoption leave
- Medical coverage
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
- 401(k) employer match
- Stock purchase options
- Employer-funded retirement account
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What This Job Offers
Job Type
Full-time
Career Level
Director
