Senior Medical Underwriter — Self-Funded & Risk Strategy

Highmark Health; Central City (KY); On-site; USD 79,000 - 127,000; Full time

Job summary

Highmark Health in the United States seeks an experienced Underwriter to price quotes and analyze group contracts based on claims experience and employee group characteristics. The role involves assessing risk, preparing reports, and ensuring profitability while guiding analysts, brokers, and clients in line with underwriting policies.

Candidate will apply actuarial insights, adapt pricing to market dynamics, and support compliance and product development efforts.

Qualifications

• Bachelor's degree in Mathematics, Actuarial Science, Finance, Business or other quantitative field
• Substitutions: ~6 years relevant, progressive experience in area of specialization
• Experience: ~5-7 years underwriting self-funded and converting fully insured prospects to self-funding

Responsibilities

• Manage a book of business for renewals and new business at profitable levels
• Calculate rates and interpret pricing policy
• Identify renewal risk patterns and advise on pricing adjustments
• Apply corporate risk management policies and adjust pricing for unusual cases
• Ensure client compliance with risk management policies and enrollment criteria
• Advise on pricing adaptations for client-specific situations
• Analyze member risk and coordinate with internal teams to mitigate it
• Support fraud detection, compliance, wellness and product development initiatives
• Complete renewals and quotes timely; review lower-level analyst work

Skills

Stakeholder management

Analytical thinking

Financial analysis

Pricing & rate setting

Communication skills

Negotiation

Education

Bachelor's degree in quantitative field

~6 years relevant, progressive underwriting experience

5-7 years underwriting experience

Tools

Underwriting software

Job description

Highmark Health in the United States seeks an experienced Underwriter to price quotes and analyze group contracts based on claims experience and employee group characteristics. The role involves assessing risk, preparing reports, and ensuring profitability while guiding analysts, brokers, and clients in line with underwriting policies.

Candidate will apply actuarial insights, adapt pricing to market dynamics, and support compliance and product development efforts.