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   Current UPMC employees must apply in HR Direct

Underwriter IV, Health Plan

Description

UPMC Health Plan has an exciting opportunity for a full-time Underwriter IV. This will be a Monday through Friday daylight position. Due to COVID-19 circumstances, this position will temporarily work remotely and will eventually transition to a partial office-based role.


The Underwriter IV will perform the most complex rating projects for the largest and/or high profile groups; to assist the underwriting department manager with administrative tasks, to provide peer review at the highest non-managerial level; to represent the underwriting department in meetings with other functional areas. An Underwriter IV works in conjunction with the manager of the underwriting department to construct and maintain the underwriting guidelines; to interact with all the various departments that underwriting supports or receives support from; to stay current with state regulations and FEHB requirements and implement processes to ensure compliance to these entities; to act as a mentor/trainer for the underwriting department as it pertains to risk assessment, including the determination of both the financial and non-financial impact to the Health Plan. The Underwriter IV works in conjunction with the manager of underwriting and actuarial services to ensure that the underwriting rating process is in line with the Health Plan's financial projections as determined by the Finance Department.


Responsibilities:
  • Manage and develop the entire underwriting department with focus on the small group underwriters, medical underwriters and administrative staff.
  • Lead the underwriting staff in developing new and more effective ways to illustrate and communicate cost drivers and rate justifications.
  • Take an active role in the peer review of the work of Large Group Underwriters based on Authority Guidelines.
  • Develops and maintains the underwriting policy, procedure and guidelines.
  • Responsible for conducting all performance reviews for the department.
  • Assist department manager with administrative tasks including assignment of cases to underwriters, distribution of plan grids from product development, case tracking, reporting and other administrative items.
  • Utilizes and applies the underwriting guidelines appropriately and the ability to perform additional risk analysis.
  • Responsible for maintaining an individual case load which will include the largest, most complex and/or high profile groups.
  • Responsible for managing the day to day activities of the Underwriting department.
  • Monitor plan performance and develop a plan of action to deal with situations when results deviate from the expected values.
  • Monitor Large Group Underwriting book of business results and communicate to underwriting team.
  • Manages the development and maintenance of training documents and processes for the staff relative to experience rating and the explanation of the developed rates.
  • Work with underwriting management and Actuarial Services in the development of underwriting policy, procedures and rating tools.
  • Serve as a resource for pricing and risk analysis expertise.
  • Works in conjunction with actuarial department to develop and maintain rating tools.
  • Deliver and explain renewal rating actions to current clients as well as rating actions to prospective clients and their consultants/brokers.

Qualifications

  • Bachelor's degree with a major in Mathematics, Finance, or Business Administration is required or equivalent work history.
  • Minimum of seven years of experience in group underwriting is required.
  • Extensive exposure to rating group business based on claims experience and alternative funding methodologies, as well as with selection issues involved in small group rating. 
  • Must possess computer skills, including knowledge of Excel, and demonstrate competency in mathematics, attention to detail, and the ability to work in teams.
  • Experience with an insurance carrier as well as a consulting firm preferred.
  • Previous supervisory or management experience preferred.

Licensure, Certifications, and Clearances:



UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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