Assistant Vice President – Cost Containment, Employer Stop-Loss

This is a fully remote position, open to applicants in United States.

📋 Description

• Take charge of the daily implementation of Skyward's cost-containment initiative across the stop-loss portfolio.

• Create and enhance cost-containment procedures, standard operating protocols (SOPs), and playbooks.

• Assess and monitor the performance of cost-containment vendors.

• Support the VP in vendor selection, conducting due diligence, and evaluating contracts.

• Track, quantify, and report on cost-containment savings.

• Stay updated on emerging cost drivers, treatment modalities, regulatory shifts, and market trends.

• Offer senior-level clinical expertise on complex, high-cost, and sensitive claims.

• Establish and maintain executive-level relationships with TPAs, producers, policyholders, and cost-containment vendors.

• Act as a senior mentor and resource for Clinical Consultants.

• Identify opportunities to utilize data and analytics to enhance cost-containment results.

• Design and uphold SOPs, workflows, and documentation standards.

⛳️ Requirements

• A minimum of 10 years of progressive experience in cost containment, clinical risk management, or managed care within a broker, stop-loss, reinsurance, or insurance carrier environment.

• Proven expertise in designing stop-loss or reinsurance cost-containment programs, managing vendors, and delivering savings.

• Experience in management or leadership roles.

• Extensive knowledge of cost-containment vendors, strategies, and the market landscape.

• Strong understanding of employer stop-loss contracts, claims adjudication, and the TPA/broker/policyholder ecosystem.

• Demonstrated ability to cultivate and sustain relationships with brokers, TPAs, and vendors at a senior level.

• Bachelor's degree or equivalent professional experience.

🏝️ Benefits

• Health and welfare benefits.

• Tuition and professional certification support.

• 401k savings plan.

• Optional participation in the Employee Stock Purchase Program.

• Paid time off.

• Paid holidays.

• Child bonding leave.

• Additional employee assistance programs.