VP of Stop-Loss Underwriting

Cambia Health Solutions • Medford, OR

13d • Remote

About The Position

The VP of Stop-Loss Underwriting manages stop loss book of business risk selection and risk classification activities to meet top line growth and bottom-line profitability objectives. This role is the Cambia-wide final decision maker for stop loss concessions on rates and terms prior to escalation. The position plans, develops, and directs the activities of the Underwriting Stop Loss departments within Cambia to meet corporate objectives for stop loss risk management, renewal activity, and new business production. It also secures necessary capabilities for stop loss business, such as premium and billing systems, reporting systems, and UM/CM capabilities. The role actively engages with state insurance departments to initiate and/or resolve filing issues and drives the process to evaluate and approve external Third-Party Administrators. The VP represents Cambia and CBRM in AM Best presentations, all in service of creating a person-focused health care experience.

Requirements

• Bachelor's degree in business, math, statistics or related discipline.
• 12+ years underwriting experience in the health insurance profession with specific responsibilities in stop loss or equivalent combination of education and experience.
• In-depth knowledge of the health care industry and specifically in the self-funded employer stop loss market; including underwriting principles, alternative funding models, administration, market and regulatory requirements.
• Strong knowledge with complex mathematical concepts and ability to communicate abstract concepts to lay personnel.
• Requires a 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.

Nice To Haves

• Demonstrated ability to leverage AI tools and resources to drive efficiency and innovation within area of expertise.

Responsibilities

• Manages stop loss book of business risk selection and risk classification activities to meet top line growth and bottom-line profitability objectives.
• Serves as the Cambia-wide final decision maker for stop loss concessions on rates and terms prior to escalation.
• Plans, develops, and directs the activities of the Underwriting Stop Loss departments to meet corporate objectives for stop loss risk management, renewal activity, and new business production.
• Secures necessary capabilities for stop loss business, including premium and billing systems, reporting systems, and UM/CM capabilities.
• Actively engages with state insurance departments to initiate and/or resolve filing issues.
• Drives the process to evaluate and approve external Third-Party Administrators.
• Represents Cambia and CBRM in AM Best presentations.
• Develops strategies to meet corporate goals for contribution to reserves by line of business through rating, reimbursement, and risk management strategies.
• Establishes quote authority limits for all stop loss underwriters.
• Reviews and signs off on all cases above the underwriter's quote authority limits and all exception cases.
• Responsible for the development and maintenance of the Underwriting Guidelines, annual stop loss underwriting audits of all underwriters, and oversight of the stop loss contracts.
• Directs development and implementation of policies and procedures in compliance with corporate strategies and legislative mandates.
• Directs the development and application of equitable and competitive rates to groups to assure favorable underwriting.
• Directs the development and implementation of underwriting policies that preclude adverse selection and provide the opportunity of coverage to specified communities.
• Maintains an optimum balance between an adequate rate structure and stop loss coverage that is competitive in the marketplace.
• Provides support and analysis to the Senior Vice President and Chief Actuarial Officer.
• Monitors and recommends changes to manual rate and factor development to ensure optimal outcomes for sales, renewals, and underwriting gain.
• Leads a team of Managers, Stop Loss Underwriters, Stop Loss Claims Analysts, Medical Risk Consultants, and support personnel.
• Directs work product and production of assigned stop loss underwriting nurse staff.
• Demonstrates ability to leverage AI tools and resources to drive efficiency and innovation within Stop-Loss Underwriting.
• Demonstrates ability to read the self-funded employer stop loss marketplace with regards to rate sensitivity and product offerings.
• Demonstrates competency to think analytically, apply analytical techniques, and provide in-depth analysis and recommendations using critical thinking and sound judgment.
• Demonstrates competency to apply and interpret quantitative data for decision-making.
• Demonstrates competency working with complex computer software systems.
• Demonstrates competency in effective communication, verbally and in writing, with all levels of the work force.
• Demonstrates competency to establish and maintain effective working relationships with executives, managers, supervisors, sales professionals, and brokers.
• Demonstrates ability to work with all levels of staff and management both as a self-starter and in a team environment.
• Demonstrates ability to promote new visions and ideas and gain "buy in" from senior leadership, management, and peers.
• Demonstrates strong knowledge in planning, organizing, and leading the work of others with minimal supervision, while developing departmental goals and objectives consistent with corporate vision and strategies.
• Ability to coach and develop Stop Loss Underwriting Managers.

Benefits

• Competitive base pay
• Market-leading 401(k) with a significant company match
• Bonus opportunities
• 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: Executive