Last Search:vp home health operationsmedical istant mcdowell mountain ranch medical group north scottsdaleclinical research ociate neuroscience immunology cincinnati oh chicago il detroit mi home based pra health sciencesmedical istant senior occupational medicine enidnurse lpnlvnallied health georgia alabama
Resp & Qualifications This position is responsible for the attainment, effective management, and profitability of a designated book of business.
This position utilizes underwriting judgement and exercises a level of authority. Pricing concessions are permitted up to the designated level of authority without further review.
This position works closely with Sales and Account Management to ensure that client needs are met without compromising the corporate objectives of CareFirst.
This position is responsible for monitoring financial performance and apprising management as needed.PRINCIPAL ACCOUNTABILITIES : Under the direction of the Manager, the essential duties and responsibilities include, but are not limited to, the following : 1.
Support attainment of corporate sales and profitability goals through the completion of new business quotes (e.g. demographics, claims experience, benefit levels, contribution strategy, carrier history, etc.
and the development of appropriate new business rates. The new business quote process includes the following requirements : A.
Completing Basic (Demographically Rated) quotes.B. Completing Complex (Experience Rated) quotes.C. Completing Stop Loss and ASO quotes.
D. Applying underwriting judgment when appropriate.E. Preparing RFP responses.F. Meeting the stated close ratio goals.G. Meeting average turnaround time goals.
H. Providing clear documentation and file maintenance.I. Using the latest actuarial tables and factors.2. Ensure the retention and profitability of existing business through the calculation of appropriate renewal rates.
He / she utilizes all currently available information, factors and formulae to accurately predict future claims and non-claims expenses.
Works closely with the Account Manager and Underwriting Manager to provide alternate benefit plans, risk and / or funding arrangements.
Upon notification of renewal acceptance, he / she will update appropriate billing rate files, contracts, internal databases, etc.
The renewal process includes the following requirements : A. Completing Large Group Risk Renewals, with an emphasis on larger and more complex accounts.
B. Completing ASO / Stop Loss Renewals.C. Quoting alternate benefit designs.D. Quoting alternate funding arrangements.E. Updating Final Rates (Risk).
F. Updating Internal Databases.G. Updating ASO & Stop Loss Contracts as appropriate.H. Meeting stated persistency goals.I.
Meeting all average turnaround time goals.J. Managing concessions within established book of business targets.K. Providing clear documentation and file maintenance.
L. Using the latest actuarial tables and factors.M. Reviewing settlements as necessary.3. Monitor financial performance of assigned book of business to provide advance notice of potential adverse outcomes to Underwriting Department management.
Provide technical expertise and support to Account Managers regarding potential benefit changes and / or alternatives available to the account.
Ensure account performance is accurately reflected on corporate financial statements and forecasts.4. Provide support to Sales and Account Management staff on Underwriting related issues.
Provide support to Finance, Legal, Operations, etc. as requested. Necessary support includes the following items : A. Communicating and negotiating directly with prospects, existing accounts, brokers & consultants.
B. Participation in conference calls with prospects, existing accounts, brokers and consultants.C. Attending meetings with prospects, existing accounts, brokers and consultants.
D. Performing miscellaneous functions that support the department on as needed basis.E. Acting as a backup when the manager is out of the office.
5. Participate in formal and informal training activities to develop and enhance knowledge of underwriting methodologies, funding options, products, legislation, CareFirst competitors, and to ensure compliance with corporate and departmental policies.
Necessary training includes the following items : A. Participation in internal and external courses.B. Providing Training Support, Mentoring and Coaching to Underwriting staff.
C. Becoming proficient in new underwriter tools and applications.D. Continuing to improve computer skills.6. Produces and monitors the issuance of Underwriting departmental reports for both internal management and external customers.
Utilizes available data to isolate specific elements of account benefit plan performance and to support required rate actions as requested.
7. Participate and have an active role in department special projects, while embracing change in a positive manner. Provide a leadership role in department special projects when necessary.
QUALIFICATION REQUIREMENTS : Required : This position requires B.S In Business, Accounting, Finance or Related Field or Related Experience.
This position also requires a minimum of five (5) to seven (7) years of Group Health Underwriting experience, including medical and ancillary benefits (drug, dental, vision).
Abilities / Skills : Individual must be knowledgeable of risk selection and pricing methodologies used within the health insurance industry and at CareFirst.
Individual must also have knowledge of industry laws and regulations, products, benefit plan designs, market trends and alternate funding arrangements.
He / she should have demonstrated experience in handling large and / or complex accounts, as well as CareFirst corporate knowledge.
Position requires very good written and oral communication skills, including the ability to explain complex topics to diverse and potentially hostile audiences.
Individual should have strong PC skills and be proficient in Excel and Word. Familiarity with Power Point preferred. Good presentation skills are required.
Individual may be called upon to develop internal / external presentations and training materials for Underwriting, Sales, Brokers and Clients.
Demonstrated ability to work effectively with other areas of the company as individual may be asked to represent UW department in corporate projects and initiatives.
Must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Hire Range Disclaimer Actual salary will be based on relevant job experience and work history.Where To Apply Please visit our website to apply : www.
carefirst.com / careersClosing Date Federal Disc / Physical Demand Note : The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him / her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS : The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required.
The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear.
Weights up to 25 pounds are occasionally lifted.Sponsorship in US Must be eligible to work in the U.S. without SponsorshipPDN-9415a147-18be-4ef3-9b79-9b36526aa72b