Stop Loss Underwriter

Job Summary

Optimyl Benefits is seeking a Stop Loss Underwriter to price, quote, and analyze the structure of a contract and policy for a group employer based on group demographics, medical claims and utilization data, claims experience, and other characteristics of each unique risk. The position:

• Uses discretion of Underwriting authority within the policies of Optimyl and ensures appropriate levels of profitability and growth over time.
• Identifies when to decline quotes that do not fit the overall Optimyl strategy and risk structure.
• Analyzes risk factors for new business enrollment, annual renewals, and amendments in conformance with established underwriting policies, practices, and standards.
• Analyzes associated policies, guidelines, and market data to improve risk management, 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, and characteristics of individual participants of the group, projected future care costs and 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 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.
• The job has knowledge and experience with Optimyl procedures, policies, and protocols.
• This is a mid-level position, with little oversight by Management when performing the essential responsibilities of the position.

Essential Responsibilities:

• Responsible for a book of business of renewing accounts and writing new business at profitable levels to help Optimyl achieve overall business targets or assigned volume of new applications or RFPs.
• Uses various systems, tools, and resources to obtain necessary data and accurately complete and track assigned work.
• Evaluate eligibility of groups and the participating employees at the time of new business quote; evaluate eligibility of mid-year participating employee additions.
• Calculate rates, evaluate different financial arrangements (e.g., networks, plan designs, carveouts), interpret pricing policy, and adapt to unusual situations.
• Identifies questionable claim patterns of renewal clients and evaluates competitor’s claims experience for prospective clients and develops recommendations to account for these situations.
• Applies corporate risk management policies and adjusts for unusual situations that may not have been considered in the standard pricing formula.
• Identifies when clients do not comply with corporate risk management policies, disclosure rules, or conditions/criteria for enrollment.
• Enforce Optimyl's business rules (participation, product availability, etc.)
• Recommends appropriate adaptation of pricing within the appropriate policy or guideline to accommodate each client-specific situation.
• Analyzes individual member risk and aggregate to the total group.
• Supports other internal initiatives which may include but is not limited to underwriting policies and procedures, training, fraud detection, corporate compliance, and product development efforts.
• Completes renewals, prospective quotes, review of lower level analyst (Underwriting Assistant) work in accordance with production and timeliness standards.
• Adapts to changing priorities as quotes come in from different markets and adapt to new priorities and requirements.
• Communicates recommendations of policy adaptation to accommodate client-specific situations or changes to overall policy supported by a clear rationale or management principles.
• Serve as a SME to sales and account management.
• Influences Sales team and external audiences toward appropriate risk solutions.
• Influences Sales team toward the appropriate pricing and structure of each quote. When necessary, influences other market partners, e.g. brokers.
• Guides, assists, and provides technical assistance to lower-level analysts.
• As assigned, assume primary support for maintenance of departmental tools and processes.
• As assigned, represent departmental perspectives and needs on system development and process improvement teams.

Required Education:

• Bachelor’s degree in mathematics, Actuarial Science, Finance, Business, Computer Science, or other quantitative analysis discipline.

or

• 6 years of relevant progressive experience 

Required Experience:

• 3 - 5 years in Underwriting stop loss new business and renewals
• Proven track record of writing profitable business

Competencies and Skills:

• Skilled and knowledgeable interaction with various internal departments and external stakeholders.
• Ability to use applicable computer systems 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.
• Good problem-solving, organizational, and negotiation skills.
• Excellent math aptitude required to complete analysis.