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Sr. Underwriter - Texas City Texas
Company: Sentara
Location: Texas City, Texas
Posted On: 11/21/2024
AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Sr. Underwriter in Miami and/or Gainesville, Florida. This is a hybrid position, 2 days in office and 3 days remote if within local market or 100% remote if outside of local territory.
Scope of position: The Sr. Underwriter reviews and analyzes risks posed by employer groups requesting group health coverage and develops employer group-specific premium rates for all large group and self-funded products. Assists with the development and implementation of procedures for monitoring the overall effectiveness of the underwriting function.
Essential Job Functions:
- Analyzes employer group experience reports from both internal and external sources in connection with group-specific premium rate development. Develops studies, reports and analysis to respond to specific underwriting issues. Evaluates medical risk for employer groups. Determines premium rates for prospective clients.
- Determines rates and fees for self-funded employer groups, procures stop loss quotations from outside insurance carriers, and produces and presents final proposals based on client-specific requirements. Processes requests for self-funded renewals, completes stop-loss carrier requirements for renewal rate changes, disclosures, and final offers.
- Collaborates with sales by participating in meetings and/or conference calls with employer groups, outside brokers and consultants.
- Attends and participates in Pricing Strategy Council meetings for review of Strategic Account prospects and renewals. Interacts with SVPs and Marketing Directors concerning final recommendations for rating actions or fee recommendations.
- Collaborates with other departments to implement new rates, rating methodologies and applications. Performs implementation testing for changes to rating and workflow programs needed to underwrite prospects and renewing clients. Recommend changes to programs when necessary.
- Assists in the development and maintenance of documentation on quote processes and underwriting guidelines, including department Underwriting Manual. Maintain ASO database, Retention Tracker and Block Budget.
- Documents risk evaluation findings and maintain acceptable records for review and audit by regulatory authorities.
- Produces and maintains reports and reporting systems to monitor and assist in renewal and new business processes. Presents report findings and recommendations to leadership for review and approval.
- Develops, produces and maintains Block Renewal reporting for presentation to Senior Management at monthly Block Renewal meetings. Coordinate development and maintenance of methodologies and data sources with Group Actuarial. Develop and maintain Block Renewal Report for Senior Management review on a monthly basis.
- Performs additional duties and responsibilities as assigned by management
Minimum Requirements:
- Bachelors required
- 6-10 years of experience in Underwriting in HMO or health insurance or related field with medical risk evaluation and financial analysis experience
- An equivalent combination of education and experience may be considered
Preferred Requirements:
- Health Insurance Portability and Accountability Act (HIPAA)-Proficiency: Advanced
- Manage Projects- Proficiency: Advanced
- Problem Solving- Proficiency: Advanced
- SQL, VBA and/or SAS- Proficiency: Intermediate
- Microsoft Office (Word, Excel Access, Outlook)-Proficiency: Intermediate
Our Benefits:
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
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