Highmark Health Underwriting Senior Consultant in Pittsburgh, Pennsylvania

Company :

Highmark Inc

Job Description :

I. GENERAL OVERVIEW:

The Underwriting Consultant participates with multiple disciplinary groups to evaluate and calculate rates for complex, highly visible renewal and prospect clients; develops key relationships by expertly conveying departmental perspectives and risk management rationales; contributes to the development and execution of sales strategies and tactical initiatives; analyzes risks of underlying policies, annual renewals, and amendments of group insurance contracts, or of self-funded plans in conformance with established underwriting policies, practices, and standards; and analyzes data such as financial conditions of the organization, participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine appropriate rates and benefits to compensate for risk associated with renewal accounts and prospect clients.

In addition, the Consultant provide consultative financial and risk management support to Sales and other areas that leads to a differentiated customer experience; provides Sales and Underwriting management analyses, reports and tools needed to develop and monitor strategic initiatives; prepares a variety of reports, procedures or results and provides rationale and support to other areas within the organization and to clients or producers regarding underwriting results, rate computations and financial activity; provides expense estimates and accurate analysis of financial exhibits; and provides training and mentoring to lower level analysts.

II. ESSENTIAL RESPONSIBILITIES:

  1. Responsible for a book of business of renewing accounts. Utilizes various systems and tools to obtain necessary data and accurately complete and track assigned work.

  2. Rating and Analysis

• Calculates rates, employs different financial arrangements, interprets pricing policy and adapts to unusual situations evident with complex, highly visible clients.

• Identifies questionable claim patterns of renewal clients and issues with competitor’s claims experience for prospect clients and develops recommendations to account for these situations.

  1. Risk Analysis

• Identifies when clients to not comply with corporate risk management policies.

• Implements appropriate adaptation of policies to accommodate complex client specific situations.

• Distinguishes between critical and non-critical informational needs in risk management negotiations and modifies arrangements depending on the information available.

• Discusses alternative risk management and pricing methods in use by the company and/or others in the industry and provides advantages and disadvantages to each method.

  1. Production Standards

• Completes renewals, prospect quotes and review of lower level analyst work in accordance with production standards.

  1. Effective Communication

• Provide solid and persuasive arguments for appropriate risk management and pricing decisions.

• Move Sales and external audiences toward appropriate risk solutions to assure favorable risk selection.

• Support Management in explaining, interpreting and applying company and departmental goals and objectives.

  1. Team Role

• Support and promote adherence to department and company policies, procedures and norms.

• Mentor and guide lower level analysts through shared experiences and knowledge.

  1. Strategic Planning and Analysis (as assigned to higher level Consultants)

• Act as Underwriting liaison to facilitate planning and analysis and refine Sales’ strategic initiatives.

• Coordinate components and timing of financial reporting packages specific to the needs of individual clients.

• Gather and analyze financial data and present results to the interdisciplinary team.

• Develop customized financial analysis and reporting tools as needed.

• Facilitate negotiations based on a thorough understanding of factors that influence the industry and competitive conditions.

• Deliver a differentiated customer experience on an on-going basis by proactively collaborating with Sales to provide innovative, customer focused support services.

  1. Other duties as assigned or requested.

III. QUALIFICATIONS:

Minimum

• Bachelor Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline.

• 10-15 years of related progress experience in the area of specialization including experience in leading large projects

• Pennsylvania Producer’s License in Accident and Health or a willingness to pursue and obtain a Producer’s License within six months.

• A professional designation related to the healthcare industry, from an organization such as (but not limited to) HIAA/AMHC, CEBS, SOA or be willing to obtain a professional designation within two years.

• Minimum years of Underwriting experience varies by level.

Preferred

• Ongoing compliance with all requirements to keep the PA Producer’s License in Accident and Health and professional designations.

Knowledge, Skills and Abilities

• Skilled and knowledgeable interaction with various internal departments and external stakeholders.

• Ability to use applicable computer systems, electronic tools and applications.

• Ability to work independently and assume responsibility for projects across a continuum from routine to highly complex.

• 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.

IV. SCOPE OF RESPONSIBILITY

Does this role supervise/manage other employees? No

V. WORK ENVIRONMENT

Is Travel Required? Yes


Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( http://www1.eeoc.gov/employers/upload/eeocselfprint_poster.pdf )

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For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

Highmark Health and its subsidiaries and affiliates comprise a national health and wellness organization that employs more than 40,000 people and serves nearly 50 million Americans in all 50 states and the District of Columbia. The organization includes businesses in health insurance, health care delivery, managed vision care, retail eyewear and eye care services, eyewear manufacturing, dental solutions, health risk solutions, and innovative, technology-based solutions. Highmark Health is the parent of Highmark Inc., Allegheny Health Network, HM Health Solutions, and HM Home and Community Services LLC.