Job Description
Analyzes risk factors for new enrollment, annual renewals, and amendments of group insurance contracts or of self-funded plans in conformance with established underwriting policies, practices, and standards. Analyzes associated policies, guidelines, market data to continuously improve risk management and gain appropriate enrollment or manage existing membership. Analyzes data such as financial conditions of the organization, participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered and to set the rates. Prepares a variety of reports and provides rationale and support to other areas within the organization, clients, and possibly producers regarding one or more of the following: underwriting results, rate computations and financial activity. Provides expense estimates and accurate analysis of financial exhibits.
RESPONSIBILITIES
• Responsible for a book of business of renewing accounts and writing new business at profitable levels to help organization achieve overall business targets or assigned volume of new applications or RFP’s.
• Utilizes various systems and tools to obtain necessary data and accurately complete and track assigned work.
• Review and complete Rating and Analysis work with guidance and technical oversight from other staff.
• Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations.
• Identify questionable claim patterns, issues with competitor’s claims, and develop recommendations for prospect and renewal clients to account for these situations.
• Apply corporate risk management policies and adjust for unusual situations that may not have been considered in the standard pricing formula.
• Identify when clients do not comply with corporate risk management policies, disclosure rules, or conditions and criteria for enrollment.
• Recommend appropriate adaptation of pricing within the appropriate policy and guidelines to accommodate each client specific situation.
• Analyze member risk and engage internal departments to manage this risk.
• Support other internal initiatives which may include but not limited to fraud detection, corporate compliance, wellness/disease management, and product development efforts.
• Complete renewals, prospect quotes, in accordance with production and timeliness standards.
• Adapt to changing priorities as quotes come in from different markets and adapt to new priorities and requirements.
• Communicate recommendations of policy adaptation to accommodate client-specific situations supported by a clear rationale or management principles.
• Influence sales and external audiences toward appropriate risk solutions.
• Influence sales team towards the appropriate pricing and structure of each quote.
QUALIFICATIONS
• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline required or 6 years relevant, progressive experience in the area of specialization.
• 1 year of experience in Insurance, Underwriting of Self-Funded and/or fully insured prospects preferred.
• Ability to use applicable computer systems, electronic tools and applications.
• Ability to work independently and assume responsibility for routine projects.
• Demonstrate an understanding and support of corporate and departmental goals and initiatives.
• Demonstrate ethical business practices with adherence to all privacy and confidentiality policies and regulations.
• Good problem-solving, organizational, and negotiation skills required.
• Excellent math aptitude required to complete analysis.
• Certified or trained in Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health Insurance Plans (AHIP), preferred.
RESPONSIBILITIES
• Responsible for a book of business of renewing accounts and writing new business at profitable levels to help organization achieve overall business targets or assigned volume of new applications or RFP’s.
• Utilizes various systems and tools to obtain necessary data and accurately complete and track assigned work.
• Review and complete Rating and Analysis work with guidance and technical oversight from other staff.
• Calculate rates, employ different financial arrangements, interpret pricing policy and adapt to unusual situations.
• Identify questionable claim patterns, issues with competitor’s claims, and develop recommendations for prospect and renewal clients to account for these situations.
• Apply corporate risk management policies and adjust for unusual situations that may not have been considered in the standard pricing formula.
• Identify when clients do not comply with corporate risk management policies, disclosure rules, or conditions and criteria for enrollment.
• Recommend appropriate adaptation of pricing within the appropriate policy and guidelines to accommodate each client specific situation.
• Analyze member risk and engage internal departments to manage this risk.
• Support other internal initiatives which may include but not limited to fraud detection, corporate compliance, wellness/disease management, and product development efforts.
• Complete renewals, prospect quotes, in accordance with production and timeliness standards.
• Adapt to changing priorities as quotes come in from different markets and adapt to new priorities and requirements.
• Communicate recommendations of policy adaptation to accommodate client-specific situations supported by a clear rationale or management principles.
• Influence sales and external audiences toward appropriate risk solutions.
• Influence sales team towards the appropriate pricing and structure of each quote.
QUALIFICATIONS
• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline required or 6 years relevant, progressive experience in the area of specialization.
• 1 year of experience in Insurance, Underwriting of Self-Funded and/or fully insured prospects preferred.
• Ability to use applicable computer systems, electronic tools and applications.
• Ability to work independently and assume responsibility for routine projects.
• Demonstrate an understanding and support of corporate and departmental goals and initiatives.
• Demonstrate ethical business practices with adherence to all privacy and confidentiality policies and regulations.
• Good problem-solving, organizational, and negotiation skills required.
• Excellent math aptitude required to complete analysis.
• Certified or trained in Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health Insurance Plans (AHIP), preferred.
Additional Details
Experience: 5-10 years