Underwriter I, II, III or Senior

Cambia Health Solutions • Salt Lake, UT

3d • Hybrid

About The Position

Every day, Cambia’s dedicated team of Underwriters is living our mission to make health care easier and lives better. As a member of the Underwriters team, our Underwriters Evaluate assigned group eligibility and risk and assign the appropriate rate for new and renewal groups across small and large group segments – all in service of creating a person-focused health care experience. This is a hybrid role, requiring 3 days per week in the office. Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, and Lewiston offices or who are willing to relocate.

Requirements

• Underwriter I: Bachelor's degree in business, math, statistics, or related discipline; or equivalent combination of education and experience.
• Underwriter II: Bachelor's degree in business, math, statistics, or related discipline and a minimum of 3 years of related experience; or equivalent combination.
• Underwriter III: Bachelor's degree in business, math, statistics, or related discipline and a minimum of 5 years of related experience; or equivalent combination.
• Underwriter Senior: Bachelor's degree in business, math, statistics, or related discipline and a minimum of 8 years of related experience; or equivalent combination.
• Demonstrated analytical and problem-solving skills.
• Business acumen including finance, accounting, economics, and risk management principles.
• Effective verbal and written communication skills.
• Ability to build and maintain positive internal and external customer interactions.
• Ability to prioritize tasks and meet deadlines.
• Demonstrated technology proficiency, including Excel, Word, and applicable software applications.
• Demonstrated success managing competing priorities and workload.
• Ability to work independently, meet deadlines, and achieve standards.
• Proven attention to detail and accuracy in data entry and other administrative tasks.
• Understanding of fundamental negotiation principles and company policies.
• Demonstrated proficiency working with complex computer software systems and automation.
• Ability to effectively explain complex mathematical and abstract concepts to a variety of stakeholders, including those with less familiarity or understanding.
• Advanced knowledge of healthcare benefits and programs.
• Confidence in presenting terms and defending underwriting decisions.
• Strong problem-solving skills with the ability to investigate and resolve complex issues.
• Proven understanding of business, including finance, accounting, economics, and risk management.
• Demonstrated attainment of a high level of independent, consistent performance.
• Ability to organize, plan, prioritize, and complete complex assignments with little or no supervision.
• Ability to document processes and procedures.
• Demonstrated ability to read the marketplace and competitive environment.
• Expertise in alternate funding arrangements and underwriting policies and procedures.
• Wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
• Access to a personal mobile device to set up Multi-Factor Authentication (MFA).

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

Responsibilities

• Follow underwriting guidelines, policies, procedures, and formulas in developing and assigning rates for new and renewal groups, including alternative benefit variations and complex funding arrangements.
• Verify employer eligibility to purchase and renew group products, ensuring all groups meet minimum participation and contribution requirements.
• Audit new and renewing groups as necessary to ensure compliance with underwriting and legislative guidelines.
• Validate that all required documentation received is complete and properly executed.
• Approve renewal changes after verifying rates and product selection.
• Maintain complete and accurate records and documentation in underwriting systems.
• Identify and resolve data discrepancies and processing errors.
• Monitor application status and ensure timely processing through workflow systems.
• Gather appropriate data to determine the status of account refunds.
• Maintain spreadsheet information on group renewal history.
• Use independent judgment, or judgment with appropriate level of peer/manager review, to evaluate system-generated rate calculations for reasonability.
• Utilize applications to support the rating and underwriting process, including but not limited to StepWise, Salesforce, claims systems, and other reporting databases.
• Prepare memos and other correspondence to communicate changes in rates or benefits.
• Process appropriate paperwork associated with renewal rate actions and proposal closings.
• Maintain a working knowledge of State and Federal regulations, including the Affordable Care Act, affecting group rating.
• Assist in training more junior level Underwriters.
• Work independently to prioritize work, meet deadlines, and achieve standards.
• Prepare retrospective settlements.
• Analyze reinstatement requests to grant or deny approval.
• Advise internal teams on underwriting questions and issue resolution.
• Support management reporting efforts and the development of automated rating and analysis tools.
• Develop and prepare federal and state reporting documents.
• Answer questions regarding the basic factors used in developing rates.
• Proactively suggest alternative benefit options and determine rates for alternative benefit variations and more complex funding arrangements.
• Support all types of group clients, including self-funded companies, associations, and national accounts.
• Actively participate in the review and maintenance of underwriting guidelines.
• Conduct user acceptance testing of underwriting and front-end systems.
• Provide training to non-underwriting departments, including Sales, on underwriting policies and procedures as necessary.
• Use independent judgment to evaluate system-generated rate calculations for reasonability.
• Answer questions regarding the factors used in developing rates, including group size, type of benefits, age/gender composition, large claims, experience from prior carriers, and current rates.
• Analyze large claims to proactively identify risk patterns and develop accurate pricing models.
• Assess health risk in a group environment, including large claim analysis for ongoing claim costs.
• Review and determine whether to grant exceptions to underwriting policy.
• Ensure proper administration of underwriting and legislative guidelines for new and renewing groups.
• Handle large volume production with account-specific issues (e.g., reinstatements, eligibility standards, group identification criteria).
• Prepare rate breakouts and hierarchy definitions for group setups.
• Review and direct the preparation of experience reports for fiscal, ERISA, and retrospective premium settlements.
• May prepare written summaries of recommendations and/or conditions of coverage following each analysis.
• May prepare explanations of past rating history, documenting benefit and enrollment changes, and providing recommendations for benefit and financial options.
• Assist the Manager in the education and support of new and junior Underwriters.
• Leverage expertise in alternative funding models and benefit packages to proactively identify solutions and analyze potential risk.
• Craft clear communications to Sales documenting underwriting decisions.
• May attend broker meetings, as well as meetings with sales executives, agents, and/or groups to provide explanations of rating principles or rationale of rating positions.
• Research and resolve complex group eligibility questions.
• Recommend solutions to improve procedures and processes.
• Contribute to the development of new rating formulas, methodologies, and guidelines.
• Champion best practices as a subject matter expert.
• Represent underwriting on cross-functional workgroups and strategy sessions, serving as a department representative.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level