Large Group Underwriter I/II/III/IV

Excellus BCBS•Rochester, NY

About The Position

Summary: The Large Group Underwriter is responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases as well as managing the experience rated block of business to produce desired MLR and profit targets. This role develops both new business rate proposals and renewal rates utilizing claim, premium and enrollment information available and interacts with company sales representatives and consultants regarding rate and trend explanations and rate negotiations. This position will propose and assist in the development of process improvements such as: assisting in the design, monitoring, and updating of the quoting process in conjunction with actuarial and sales; utilizing system and software applications to full potential. Essential Accountabilities: Level I Calculates renewal rates using appropriate rating formulas and procedures and analyze projected financial impacts. Validates the final renewal rates and associated packaging is correct and ensures quality in rate releases. Creates quotes for prospective & existing customers using demographic characteristics and/or claims experience. Analyzes participation levels, contribution methodology, industry classification and other carrier information available. Performs applicable review of any necessary regulatory documentation. Applies knowledge of national and local competitive information to underwriting decisions. Facilitates the negotiation of final rates and or applicable administrative costs with enrolled and prospective customers. Evaluates benefit plan variations and partners with Sales in working directly with customer accounts, their brokers and consultants, in support of rate negotiations on new or renewal business. Partners with Sales in meeting persistency goals related to existing employer group business. Prepares documents for and facilitate discussions on executive rate reviews involving multiple levels of internal leadership and impacted business segments. Consults and coordinates with the Sales and Marketing Departments in support of specific group requirements through preparation of complex group reports and enforcement of product policies. Executes financial management on an assigned book of business. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Completes new business and renewal quotes for mid-segment and large accounts for dental and medical lines of business in all insured and/or claims based billed financial arrangements. Prepares settlements for alternatively funded groups (e.g., retrospectively rated, contingent premium, or Minimum Premium). Creates and maintain Experience Rated Monitoring and Book-of-Business tracking reports. Provides consultative analysis related to how Excellus products and discounts add value. Attends and contributes to meetings with internal and external stakeholders. Develops ad hoc reports as a supplement to the group underwriting process through query building and data extraction. May develop required premium/fees and analyze results for accuracy; makes appropriate decisions on how to proceed; analyzes inputs/outputs for reasonability. Proposes and/or assists in the development of process improvements utilizing system and software applications, such as Power BI, to full potential. Participates in cross training of Underwriting and Sales staff. Coordinates with other departments to ensure accuracy and consistency of overall account reporting. Understands, protects, and educates on the financial health of the company by making sound business recommendations and making policy exceptions when appropriate. Level III (in addition to Level II Accountabilities) Interacts with internal and external sales representatives, accounts and consultants regarding rate and trend explanations and rate negotiations. Proposes and assists in development of process improvements and automation of processes within the Underwriting Team. Assists in ad hoc projects in support of the Sales, Marketing, and Actuarial Department initiatives. Interacts with internal sales representatives and consultants regarding rate and trend explanations and rate negotiations. Explains the components of rate changes to internal and external stakeholders. Represents department and/or division as a Subject Matter Expert for various technical/system/ training issues on cross functional workgroups. Communicates updates to leadership and recommends approaches for implementing change. Provides training and mentoring to other members of the Underwriting department including review and approval of case work, systems, department processes, implementation of new policies and procedures and assisting with departmental planning activities. Performs post-sale review. Assists in establishing Underwriting and Administrative procedures. Level IV (in addition to Level III Accountabilities) Responds to complex Requests for Proposal (RFP) questions and actively participates as part of the RFP response team. Evaluates and analyzes competitor rates/benefit plans for the development of trends and other renewal factors to be used in experience rating. Represents the Large Group Underwriting team in place of Underwriting management on high level, cross-functional work teams, such as Core End to End. Interacts with external customers regarding all Large Group Underwriting functions. Proposes and/or assists in the development of process improvements utilizing system and software applications. Updates and monitors departmental processes and procedures in compliance with system, regulatory and business requirements. Updates and maintains departmental reporting suites. Coordinates daily workflow activities of Underwriting staff. Reviews rate proposals from Underwriting staff. Assists in the technical development of Large Group Underwriters, which may include monitoring reports and workflow to provide recommendations on productivity and efficiency improvements.

Requirements

Bachelor’s degree in Math, Economics, Accounting, Finance, Actuarial Science, or relevant field. In lieu of degree, six (6) years of experience required. Additional degree fields and/or relevant skill sets will be considered.
Knowledge of State and Federal Laws and Regulations relating to health insurance.
Operational background with a strong ability to prioritize, plan and problem solve in a team environment.
Good analytical skills with a focus on meeting expectations and requirements of both internal partners and external customers.
Ability to extract and analyze data and implement process changes.
Excellent verbal and written communication skills.
Ability to perform under pressure and adapt to rapidly changing priorities.
Degree plus three (3) years of experience in underwriting and/or relevant field.
Knowledge of financial and risk health arrangements.
Intermediate level in Microsoft Excel, Word, Access.
Intermediate level in data extraction tools such as Cognos, Power BI, or SQL.
Degree plus five (5) years of experience in underwriting and/or relevant field.
Expert level in Microsoft Excel, Word, Access.
Expert level in data extraction tools such as Cognos, Power BI, or SQL.
Experience using software to benchmark actuarial guidelines for health rate setting.
Degree plus seven (7) years of experience in underwriting and/or relevant field.
Experience must include all lines of business, funding arrangements, and related tasks.
Ability to manage process requirements and suggest improvements for Rating tasks such as Rx Rebate Reconciliation and settlement processes.
Ability to interact and defend rate assignment process at the group and/or broker level.
Ability to assist in the workflow coordination of the team.

Responsibilities

Calculates renewal rates using appropriate rating formulas and procedures and analyze projected financial impacts.
Validates the final renewal rates and associated packaging is correct and ensures quality in rate releases.
Creates quotes for prospective & existing customers using demographic characteristics and/or claims experience.
Analyzes participation levels, contribution methodology, industry classification and other carrier information available.
Performs applicable review of any necessary regulatory documentation.
Applies knowledge of national and local competitive information to underwriting decisions.
Facilitates the negotiation of final rates and or applicable administrative costs with enrolled and prospective customers.
Evaluates benefit plan variations and partners with Sales in working directly with customer accounts, their brokers and consultants, in support of rate negotiations on new or renewal business.
Partners with Sales in meeting persistency goals related to existing employer group business.
Prepares documents for and facilitate discussions on executive rate reviews involving multiple levels of internal leadership and impacted business segments.
Consults and coordinates with the Sales and Marketing Departments in support of specific group requirements through preparation of complex group reports and enforcement of product policies.
Executes financial management on an assigned book of business.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Completes new business and renewal quotes for mid-segment and large accounts for dental and medical lines of business in all insured and/or claims based billed financial arrangements.
Prepares settlements for alternatively funded groups (e.g., retrospectively rated, contingent premium, or Minimum Premium).
Creates and maintain Experience Rated Monitoring and Book-of-Business tracking reports.
Provides consultative analysis related to how Excellus products and discounts add value.
Attends and contributes to meetings with internal and external stakeholders.
Develops ad hoc reports as a supplement to the group underwriting process through query building and data extraction.
May develop required premium/fees and analyze results for accuracy; makes appropriate decisions on how to proceed; analyzes inputs/outputs for reasonability.
Proposes and/or assists in the development of process improvements utilizing system and software applications, such as Power BI, to full potential.
Participates in cross training of Underwriting and Sales staff.
Coordinates with other departments to ensure accuracy and consistency of overall account reporting.
Understands, protects, and educates on the financial health of the company by making sound business recommendations and making policy exceptions when appropriate.
Interacts with internal and external sales representatives, accounts and consultants regarding rate and trend explanations and rate negotiations.
Proposes and assists in development of process improvements and automation of processes within the Underwriting Team.
Assists in ad hoc projects in support of the Sales, Marketing, and Actuarial Department initiatives.
Represents department and/or division as a Subject Matter Expert for various technical/system/ training issues on cross functional workgroups.
Communicates updates to leadership and recommends approaches for implementing change.
Provides training and mentoring to other members of the Underwriting department including review and approval of case work, systems, department processes, implementation of new policies and procedures and assisting with departmental planning activities.
Performs post-sale review.
Assists in establishing Underwriting and Administrative procedures.
Responds to complex Requests for Proposal (RFP) questions and actively participates as part of the RFP response team.
Evaluates and analyzes competitor rates/benefit plans for the development of trends and other renewal factors to be used in experience rating.
Represents the Large Group Underwriting team in place of Underwriting management on high level, cross-functional work teams, such as Core End to End.
Interacts with external customers regarding all Large Group Underwriting functions.
Updates and monitors departmental processes and procedures in compliance with system, regulatory and business requirements.
Updates and maintains departmental reporting suites.
Coordinates daily workflow activities of Underwriting staff.
Reviews rate proposals from Underwriting staff.
Assists in the technical development of Large Group Underwriters, which may include monitoring reports and workflow to provide recommendations on productivity and efficiency improvements.