A&H Senior Claims Cost Containment Analyst

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    "ExternalDescriptionStr": "<p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Join Westfield Specialty’s newest team!</strong><span><strong>&nbsp;</strong></span></span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Westfield Specialty’s new A&amp;H team has an opening for joining our expanding operation. As a key contributor on this highly experienced team, you'll help build a premier A&amp;H reinsurance and insurance operation. This new team offers significant opportunities for career growth and development.&nbsp;</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">The <strong>Senior Stop Loss Claims &amp; Cost Containment Analyst&nbsp;</strong>supports the Accident &amp; Health (A&amp;H) team by serving as a forward-facing liaison to cost containment vendors and customers while also providing hands-on support to stop loss and reinsurance claims operations. This role is responsible for coordinating cost containment strategies, assisting in claims production, and helping manage claims inventory and volume to ensure timely, accurate, and compliant claim outcomes.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">The position partners closely with internal claims staff, underwriting, reinsurance partners, and external vendors to drive consistency, efficiency, and strong customer experience across the stop loss and reinsurance lifecycle.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Successful candidates will have a strong knowledge of healthcare insurance policies, procedures, and regulations.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>What you will do:</strong></span></p><ul style=\"list-style-type: disc;\"><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Assist with the day-to-day activities of the A&amp;H reinsurance and stop loss claims function, from first notice through resolution.&nbsp;</span></li><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Provide exceptional customer service through all interactions and communications with internal and external business partners.</span></li><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Collaborate with management team on cost containment and claims operations</span></li><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Act as a primary point of contact for cost containment vendors (e.g., PPO networks, bill review, clinical management, specialty vendors).</span></li><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Coordinate cost containment workflows to support stop loss and reinsurance claims outcomes.</span></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Monitor vendor performance, turnaround times, and effectiveness; escalate issues as needed.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Assist in evaluating cost containment opportunities and process improvements.</span></p></li><li style=\"background-color: rgb(250, 250, 250); color: rgb(36, 36, 36); line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Assist in reviewing, processing, and adjudicating stop loss and reinsurance claims in accordance with policy provisions and regulatory requirements.</span></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Assist in developing and refining workflows, checklists, and best practices for stop loss claims and cost containment.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Contribute to training, knowledge sharing, and process documentation.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Support special projects related to claims operations, reinsurance reporting, or vendor initiatives.</span></p></li></ul><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Skills and experience:</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><ul style=\"list-style-type: disc;\"><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Bachelor’s degree or equivalent experience.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><span>&nbsp;</span>3–7 years of experience in <strong>stop loss claims, A&amp;H claims, or reinsurance-related roles</strong>.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Strong working knowledge of stop loss policy provisions and claims adjudication.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Experience working with cost containment vendors and/or TPAs</span><span style=\"font-family: &quot;Times New Roman&quot;, serif;\"><span style=\"font-size: 12pt;\">.</span></span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Ability to manage multiple priorities in a high-volume, deadline-driven environment.</span></p></li><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Strong communication skills with the ability to interact confidently with internal and external partners.</span></p></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Excellent written, verbal, and interpersonal communication skills.</span></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Strong analytic, investigative, listening, and negotiation skills.</span></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">A desire to be part of a new and growing team.</span></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Keen attention to detail.</span></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Ability to work independently.</span></li><li style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Demonstrated problem solving ability.</span></li></ul><p style=\"line-height: normal; margin-left: 0.25in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Why This Role Matters</strong></span></p><ul style=\"list-style-type: disc;\"><li><p style=\"line-height: normal;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">This role plays a critical part in supporting stop loss and reinsurance profitability, customer satisfaction, and operational stability by bridging claims execution, vendor coordination, and customer engagement. The consultant helps ensure claims are handled efficiently while maximizing cost containment outcomes and supporting the broader A&amp;H strategy.</span></p></li></ul><p style=\"line-height: normal; margin: 0in 0in 0in 0.5in;\">&nbsp;</p><p style=\"line-height: normal; margin: 0in 0in 0in 0.5in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>About Westfield Specialty</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Respected Leadership</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Jack Kuhn, President of Westfield Specialty is a highly respected industry veteran who has successfully built and scaled insurance businesses multiple times in his career. He has been responsible for U.S. and Global Insurance portfolios of more than $6B in premium across the various executive leadership roles he’s held within the insurance industry.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>A Unique Opportunity</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">“We are excited about the opportunity to establish a broad and diverse portfolio of specialty business through deep relationships and expertise.&nbsp;We’re building something that will stand the test of time.” – Jack Kuhn</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Why Join Westfield Specialty?</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Because it is a unique opportunity to be a part of building a claims organization in a start-up environment without start-up risks. No legacy baggage. Work to live – we work hard, and we play hard. We are building a new claim organization and a new claim system, and we are looking for smart, team-oriented individuals to help us create a new platform. This is a great opportunity to leave your imprint on a program that will be built to last!</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\"><strong>Excitement of a Start-Up with Stability</strong></span></p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">With a surplus of over $3 billion and an over 170-year history, Westfield combined their unprecedented financial strength, a stellar reputation, and ideal market conditions to the start-up opportunity that is Westfield Specialty.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Unique risks demand unique solutions and the&nbsp;talented&nbsp;team&nbsp;at Westfield Specialty relishes a challenge. We develop creative solutions to protect businesses and recover losses as well as drive&nbsp;growth&nbsp;for everyone in the value chain. Coverage for specialized risks requires&nbsp;creativity, and our team of experts has the knowledge and know-how that only comes from deep&nbsp;expertise. It’s that robust combination of&nbsp;stability and boldness&nbsp;that makes Westfield stand above the rest. That’s&nbsp;Westfield Specialty&nbsp;- where people make the difference!</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">Westfield Specialty is proud to be an Equal Employment Opportunity employer. We celebrate diversity and do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, veteran status, disability status, or any other applicable characteristics protected by law.</span></p><p style=\"line-height: normal; margin-bottom: 0in;\">&nbsp;</p><p style=\"line-height: normal; margin-bottom: 0in;\"><span style=\"font-family: &quot;Calibri Light&quot;, sans-serif;\">#WSP</span></p>",
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