Manager Medical Stop Loss Underwriting

Job ID: J127505
Company: HM Life Insurance Company
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Jul 12, 2018

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Description

JOB SUMMARY

This job develops, implements, coordinates, and manages all departmental operations in accordance with all applicable regulations; monitors the quality, accuracy, effectiveness and efficient delivery of all production, analysis, administration of services and reporting; ensures the integrity and consistent application of Underwriting policies and guidelines; applies judgment to develop appropriate adaptation of guidelines as deemed necessary to accommodate client specific situations; provides consultation in addressing complex client specific issues; sets results oriented performance standards and utilizes staff to their fullest potential; and provides training with the purpose of developing skills, knowledge and performance.

ESSENTIAL RESPONSIBILITIES

  • Behave in a manner that exhibits the company’s core values. Support, interpret, and promote adherence to departmental and company goals, strategies, policies, procedures and norms. Manage and develop employees by setting clear, concise performance expectations, monitoring progress, providing constructive feedback and creating an environment that encourages ongoing growth. Complete performance planning and evaluations in a timely manner. Manage own activities and others to accomplish assigned goals and objectives within agreed upon time constraints. Develop sound strategies that create a line of sight from individual to department to company goals and objectives.
  • Reviews renewal and prospect quotes to provide guidance as to whether results are reasonable and appropriate.Recommend modifications to situations that will result in adverse selection and subsequent financial loss.
  • Demonstrate an expert understanding of the contents and intent of corporate risk management policies. Identify critical information needs in risk management negotiations and modify arrangements based on the information available. Discuss alternative risk management and pricing methods in use by others in the industry and provide advantages and disadvantages to each method.
  • Oversee production to ensure timely and accurate completion of renewals and prospect quotes.
  • Develop relationships with decision makers based on trust and credibility to enhance influence on risk management and pricing decisions. Provide solid and persuasive arguments to move Sales and external audiences toward appropriate risk solutions. Enhance department influence by negotiating workable solutions, meeting deadlines and providing responsive service.
  • Lead departmental efforts in areas such as, but not limited to, pricing policy, departmental policies and procedures, product development, interdepartmental processes or corporate projects. Oversee departmental tools and processes such as, but not limited to, training, testing, reporting  and process improvement. Support all audit and market conduct reviews in order to maintain compliant rates, controls and processes.
  • Other duties as assigned or requested.

EDUCATION

Minimum

  • Bachelor Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, Nursing, Healthcare Administration or other quantitative analysis discipline

Substitution

  • 6 years of related experience

Preferred

  • None

EXPERIENCE

Minimum

  • 8 years of experience in underwriting or actuarial

Preferred

  • 12 years of experience in underwriting

CERTIFICATION/LICENSE

Minimum

  • Producer’s License in Accident and Health or a willingness to pursue and obtain a Producer’s License within six months
  • Possesses or is willing to obtain within two years, a professional designation related to the health care industry (i.e. HIAA/AMHC, CEBS, SOA) or a Licensed Registered Nurse without restriction
  • Ongoing compliance with all requirements to keep all licenses and professional designations

Preferred

  • None

SKILLS

  • Expert understanding of the contents and intent of corporate risk management policies
  • Skilled and knowledgeable interaction with various internal departments and external stakeholders
  • Ability to work independently and assume responsibility for staff and complex projects
  • Ethical business practices with adherence to all privacy and confidentiality policies and regulations
  • Proven leadership skills – ability to motivate others to quickly achieve results in a matrixed environment
  • Knowledge of industry and market trends to develop and champion long-term strategies
  • Ability to effectively persuade others to listen, commit, and act on a new approach
  • Self-confident with an ability to accept and respond to challenges in a positive manner
  • Strong and effective verbal and written communication skills
  • Effectively presents complex topics in a concise manner to audiences at various levels and in various sizes
  • Broad understanding of business issues, metrics, organizational linkages and customer value
  • Successful experience in achieving results through people in a complex environment
  • Strong organizational and analytical skills in addition to project leadership and management skills

SCOPE OF RESPONSIBILITY

Does this role supervise/manage other employees?       

Yes 

WORK ENVIRONMENT:

Is Travel Required?    

Yes  – If assigned

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 position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

Employee Referral Level 4

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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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