Medical Stop Loss Underwriting Consultant

Highmark Health; Pennsylvania; Hybrid; USD 94,000 - 151,000; Full time

Job summary

HM Insurance Group in the United States seeks an experienced underwriter to manage a block of stop loss business and lead pricing and risk analysis for renewals and new business.

You will partner with Sales, Underwriting, and Clinical teams to drive profitability, coach junior staff, and implement enhanced underwriting guidelines and tools.

Qualifications

• Required Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business Administration/Management or Computer and Information Science; substitutions 6 years of experience in lieu of degree.
• 10–15 years in Underwriting; 10–15 years in the Insurance Industry preferred.
• Certifications: CEBS, HIA, MHP, SOA (preferred).

Responsibilities

• Underwrite new and renewal business within an assigned block.
• Use rating manual, experience module and clinical expertise to create pricing that drives P/L, renewal metrics and new business sales for assigned block.
• Collaborate with Sales, Underwriting and Clinical to develop and implement pricing actions that will help HMIG meet financial targets.
• Train, coach and provide experiences to lower level staff with the purpose of expanding consultative best practices throughout the department.
• Utilize client and market knowledge to expand/enhanced Underwriting Guidelines, processes and tools by incorporating best practices.
• Monitor overall block performance and report on emerging financial trends.
• Develop strategies and tactics to move case level and block results to meet targets.
• Act as subject matter expert to support Sales' negotiations to renew existing clients and enroll new business.
• Other duties as assigned or requested.

Skills

Creative Thinking

Risk Management

Relationship Builder

Conflict Management

Solution Recommendations

Analytical Skills

Travel 0-25%

Education

Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business Administration/Management or Computer and Information Science

Job description

Company

HM Insurance Group

Job Description

JOB SUMMARY

This job participates on a multi-disciplinary team focused on highly visible, complex broker and/or TPA relationships that are organized into blocks. Some direct client interaction, but primary client contact is the sales leadership. Manages a block of stop loss business and case level underwriting within the block to achieve overall goals. Operates in a matrix structure working with the Sales, Underwriting and Clinical teams and oversees all aspects of new business and renewal pricing and risk analysis associated with select clients. Responsible for the P/L, renewal metrics and new business sales for the block. Expected to provide creative solutions on a case level and assists in the development and execution of creative solutions at the block level. Provides leadership and training to other underwriters supporting programs.

ESSENTIAL RESPONSIBILITIES

• Responsible for underwriting new and renewal business within an assigned block.
• Use rating manual, experience module and clinical expertise to create pricing that drives P/L, renewal metrics and new business sales for assigned block.
• Collaborate with Sales, Underwriting and Clinical to develop and implement pricing actions that will help HMIG meet financial targets.
• Train, coach and provide experiences to lower level staff with the purpose of expanding consultative best practices throughout the department.
• Utilize client and market knowledge to expand/enhanced Underwriting Guidelines, processes and tools by incorporating best practices.
• Monitor overall block performance and report on emerging financial trends.
• Develop strategies and tactics to move case level and block results to meet targets.
• Act as subject matter expert to support Sales' negotiations to renew existing clients and enroll new business.
• Other duties as assigned or requested.

EDUCATION

Required Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business Administration/Management or Computer and Information Science Substitutions 6 years of experience in lieu of degree Preferred None

EXPERIENCE

Required 10 - 15 years in Underwriting Preferred 10 - 15 years in the Insurance Industry

LICENSES AND CERTIFICATIONS

• Required None
• Preferred Certified Employee Benefit Specialist (CEBS)
• Health Insurance Associate (HIA)
• Managed Healthcare Professional (MHP)
• Society of Actuaries

SKILLS

• Creative Thinking
• Risk Management
• Relationship-builder with Unsurpassed Interpersonal Skills
• Conflict Management
• Solution Recommendations
• Analytical Skills
• Language (Other than English): None
• Travel Requirement: 0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

• Position Type Office-based
• Teaches / trains others regularly
• Occasionally Travel regularly from the office to various work sites or from site-to-site
• Rarely Works primarily out-of-the office selling products/services (sales employees)
• Never Physical work site required Yes
• Lifting: up to 10 pounds
• Constantly Lifting: 10 to 25 pounds
• Occasionally Lifting: 25 to 50 pounds
• Never

Disclaimer

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range

Pay Range Minimum: $94,200.00 Pay Range Maximum: $151,000.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice Highmark Health is a national, blended health organization that includes one of America's largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health's 35,000 employees serve millions of customers nationwide through the nonprofit organization's affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health's businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.