Supervisor Underwriting

Blue Cross and Blue Shield of Kansas•Topeka, KS

4d•Hybrid

About The Position

The Supervisor, Underwriting, is responsible for overseeing the eligibility, enrollment, and risk evaluation processes for group and individual business. This role ensures compliance with underwriting guidelines, manages daily operations, and provides leadership to a team of Underwriting staff. The Supervisor collaborates with Sales, Rating, Actuarial, Membership, and other internal departments to support business growth while maintaining financial stability. Additionally, this position plays a key role in training, process improvement, and cross-functional communication to enhance underwriting efficiency and accuracy. This position is eligible to work remote, hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.

Requirements

High school diploma or equivalent required
Minimum of 5 years' experience in underwriting, group rating, actuarial, or risk adjustment, with a focus on eligibility, enrollment, and risk evaluation in the health insurance industry required.
Proficiency in Microsoft Office applications (Excel, Word, Outlook, Teams) and Underwriting systems.
Excellent written and verbal communication skills, with the ability to explain complex underwriting decisions to non-technical audiences.
Strong problem-solving and decision-making abilities in evaluating risk and compliance.
Ability to manage multiple priorities, meet deadlines, and work efficiently in a team-oriented environment.
Strong leadership and coaching skills, with experience in employee development and training.
Knowledge of federal and state regulations impacting underwriting and enrollment, including ACA, HIPAA, and ERISA.

Nice To Haves

Bachelor's degree preferred.
LPN, Certified Nurses Aid or Certified Medical Aid and/or experience coding medical records using ICD 9 or 10 methodologies preferred.
Prior leadership, supervisory, and training experience preferred.
Background in medical underwriting, insurance products, regulatory compliance, and training and onboarding for underwriting teams preferred.
Strong understanding of underwriting principles, eligibility guidelines, and risk assessment methodologies.
Knowledge of medical terminology and ability to interpret health conditions for underwriting decisions.

Responsibilities

Supervise the daily operations of the Enrollment Risk area, ensuring accurate risk evaluation and underwriting decisions.
Ensure compliance with underwriting eligibility and participation guidelines for group and individual business.
Review and approve risk evaluations, ensuring appropriate documentation, follow-up, and decision-making on underwriting assessments.
Partner with Sales, Rating, Actuarial, and Membership to clarify underwriting decisions and communicate eligibility methodologies to internal and external stakeholders.
Oversee the testing and development of system enhancements, upgrades, and underwriting process improvements.
Manage external and internal communications regarding risk evaluation, eligibility, and underwriting decisions.
Provide training and ongoing education to Underwriting staff, Sales, and other departments to ensure consistency in underwriting policies and regulatory compliance.
Maintain knowledge of federal and state underwriting regulations, including HIPAA, ACA, and other applicable compliance standards.
Develop and implement workload management strategies, ensuring deadlines and department goals are met.
Conduct quality control audits on underwriting decisions and risk assessments to ensure accuracy and consistency.