Sr. Manager, Stop Loss Claims Operations (Healthcare TPA)

TL;DR

Sr. Manager, Stop Loss Claims Operations (Healthcare TPA): Leading the strategy, financial performance, and operational transformation of the stop loss claims function with an accent on reimbursement optimization, carrier negotiations, and enterprise-level system modernization. Focus on scaling operations, managing complex financial risk, and driving cross-functional leadership to ensure organizational success in a critical enterprise function.

Location: Must be based in Tempe, AZ (On-site)

Salary: $107,000–$140,000

Company

hirify.global provides a personalized health platform that integrates health plan administration, wellbeing solutions, and care navigation to reduce costs and improve health outcomes.

What you will do

• Define and execute the long-term vision, strategy, and operating model for the stop loss function.
• Drive financial performance by optimizing claim filings, reimbursement recovery, and cash flow management.
• Lead large-scale enterprise transformation initiatives, including system implementations and workflow redesigns.
• Oversee the full claim lifecycle, ensuring accuracy, compliance, and effective carrier negotiations.
• Build and evolve data analytics capabilities to surface actionable insights on claims performance and financial trends.
• Lead and develop a multi-level leadership team, fostering operational excellence and succession planning.

Requirements

• Bachelor's degree in Finance, Healthcare Administration, or Business required.
• 10+ years of experience in Stop Loss, TPA, or healthcare claims.
• 5–7+ years of progressive leadership experience managing large or complex teams.
• Expert knowledge of stop loss operations, claims management, and reimbursement processes.
• Advanced financial acumen with experience in budgeting, forecasting, and revenue optimization.
• Must be available to work on-site in Tempe, AZ on a full-time basis.

Nice to have

• Master's degree in a related field.
• Experience with Lean or Six Sigma methodologies.
• Proficiency in data visualization platforms and database management systems.

Culture & Benefits

• Comprehensive medical and dental coverage through company-provided health solutions.
• Unlimited PTO policy.
• Mental health support, retirement planning, and financial protection benefits.
• Professional development opportunities with clear career progression and learning budgets.
• Mission-driven culture focused on improving health outcomes.