Director of Claims & Stop-Loss Transformation - REMOTE

Reflect Health

is the evolution of S&S Health, a trusted independent third-party administrator founded in 1994 to meet the growing need for access, simplified connectivity, and benefits administration. Headquartered in Mason, OH, we have built a reputation based on innovation, service excellence, and a deep understanding of how to drive better outcomes at lower cost. Over the years, we grew into a national presence serving employers, TPAs, health systems, and benefit consultants across all 50 states. We developed proprietary claims technology, expanded our offerings to include level-funded and fully funded programs, and delivered tangible savings and enhanced experiences for millions of members.

We are seeking a Director of Claims & Stop-Loss Transformation to lead strategic modernization initiatives that advance the future capabilities of our claims and stop-loss platforms. Reporting to the Chief of Staff, Transformation Office, this role serves as a transformation leader responsible for assessing current-state capabilities, identifying operational gaps, designing future-state operating models, and leading complex initiatives that improve scalability, efficiency, quality, and organizational performance. This role will partner closely with Executive Leadership, Claims Operations, Stop-Loss, Technology, Finance, Compliance, Client Success, and operational teams to evaluate current performance, redesign workflows, establish accountability structures, and execute transformation initiatives that enable operational excellence. The ideal candidate is an experienced healthcare transformation with expertise in self-funded health plan administration, claims operations, stop-loss administration, business process redesign, technology enablement, operational analytics, and organizational change management. This individual must be comfortable operating as both a strategic transformation leader and a hands-on operator capable of driving measurabl