Senior Stop-Loss Underwriter — Risk & Pricing Expert

Highmark Health; Elm (PA); On-site; USD 79,000 - 127,000; Full time

Job summary

HM Insurance Group is hiring an experienced underwriter to price quotes and analyze group contracts based on claims experience and employee demographics. The role ensures profitability, growth, and adherence to underwriting policies across self-funded and fully insured programs.

You will prepare reports, support pricing decisions, and provide guidance to analysts, brokers, and clients while aligning with HMIG risk strategy and corporate compliance standards.

Qualifications

• Underwriting experience for self-funded and converting fully insured prospects.
• Bachelor's degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative field.
• 6 years of relevant, progressive underwriting experience can substitute for the degree.
• 5-7 years' underwriting experience in underwriting of self-funded and converting fully insured prospects to self-funding.

Responsibilities

• Responsible for a book of business of renewing accounts and writing new business at profitable levels to help HMIG achieve overall business targets or assigned volume of new applications or RFPs.
• Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations.
• Identify questionable claim patterns of renewal clients and issues with competitor’s claims experience for prospect clients and develops recommendations to account for these situations.
• Apply corporate risk management policies and adjust for unusual situations that may not have been considered in the standard pricing formula.
• Identify when clients do not comply with corporate risk management policies, disclosure rules, or conditions/criteria for enrollment.
• Recommend appropriate adaptation of pricing within the appropriate policy/guideline to accommodate each client specific or individual situation.
• Analyze member risk and engage internal departments to manage this risk.
• Support other internal initiatives which may include but not limited to fraud detection, corporate compliance, wellness/disease management, and product development efforts.
• Complete renewals, prospect quotes, review of lower level analyst work in accordance with production and timeliness standards.
• Adapt to changing priorities as quotes come in from different markets and adapt to new priorities and requirements.
• Communicate recommendations of policy adaptation to accommodate client-specific situations supported by a clear rationale or management principles.
• Influence sales and external audiences toward appropriate risk solutions.
• Influence sales team towards the appropriate pricing and structure of each quote. When necessary, influence other market partners, e.g. brokers and TPA’s
• Guide, assist and provide technical assistance to lower level analysts.
• Assume primary support for maintenance of departmental tools and processes, as assigned,
• Represent departmental perspectives and needs on system development and process improvement teams, as assigned,
• Other duties as assigned or requested.

Skills

Stakeholder communication

Technical proficiency

Independent work

Problem solving

Negotiation skills

Analytical math ability

Education

Bachelor's degree in quantitative discipline

Job description

HM Insurance Group is hiring an experienced underwriter to price quotes and analyze group contracts based on claims experience and employee demographics. The role ensures profitability, growth, and adherence to underwriting policies across self-funded and fully insured programs.

You will prepare reports, support pricing decisions, and provide guidance to analysts, brokers, and clients while aligning with HMIG risk strategy and corporate compliance standards.