Senior Medical Underwriter – Group & Self-Funded Plans

Highmark Health; Washington (District of Columbia); On-site; USD 79,000 - 127,000; Full time

Job summary

HM Insurance Group is seeking an experienced underwriter to price quotes and analyze group contracts based on claims experience and employee group characteristics. The role requires exercising underwriting authority within policy guidelines to ensure profitability and sustainable growth, including recognizing when a quote does not fit HMIG’s strategy.

You will assess risk factors for renewals and new enrollment, prepare reports, support pricing decisions, and provide guidance to junior analysts

Qualifications

• Bachelor's degree in mathematics, actuarial science, finance, business, computer science or other quantitative analysis discipline.
• Approximately 6 years relevant, progressive underwriting experience.
• 5–7 years of underwriting experience for self-funded and converting fully insured prospects to self-funding.

Responsibilities

• Renewals and new business pricing to meet profitability targets.
• Calculate rates and apply pricing policy; interpret pricing guidance.
• Identify questionable claim patterns and advise on pricing implications for prospects.
• Apply corporate risk management policies and adjust pricing for unusual situations.
• Ensure client enrollment complies with risk management and disclosure rules.
• Recommend pricing adaptations for client-specific situations.
• Analyze member risk and coordinate with internal teams to manage it.
• Support fraud detection, compliance, wellness initiatives, and product development.

Skills

Stakeholder interaction

Computer systems proficiency

Independent work

Policy alignment

Privacy compliance

Problem solving

Math aptitude

Education

Bachelor's degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative field

Job description

HM Insurance Group is seeking an experienced underwriter to price quotes and analyze group contracts based on claims experience and employee group characteristics. The role requires exercising underwriting authority within policy guidelines to ensure profitability and sustainable growth, including recognizing when a quote does not fit HMIG’s strategy.

You will assess risk factors for renewals and new enrollment, prepare reports, support pricing decisions, and provide guidance to junior analysts