Resp & Qualifications
This position is directly responsible for the day to day management and oversight of a staff of 5 to 10 underwriters. This includes recruiting, hiring, auditing performance management, training, motivating, mentoring, coaching and account level guidance to the underwriters who make decisions regarding risk assumption and pricing, including but not limited to new business and renewals with the focus on enhancing profitability of the operation and increasing market share. This position manages, reviews and approves the work output of the entire unit, and provides significant feedback to the Senior Director regarding staff performance. This position is also directly responsible for the attainment, effective management, and profitability of a designated book of business.
This position serves as a companywide resource on matters pertaining to Underwriting and represents the department on cross-functional teams and projects, including but not limited to new product lines (i.e. diversified benefits, dental, vision, pharmacy), network changes, alternate funding arrangements, and ACA requirements. This position participates in strategic and tactical planning, as well as recommends and implements process improvements. This position is responsible for monitoring financial performance, competitive positioning, and taking appropriate corrective actions as needed.
This position works closely with Sales and Account Management Directors to ensure that client’s needs are met without compromising the corporate objectives of CareFirst.
This position will interact regularly with the broker community and have direct involvement with the creation, maintenance and monitoring of Mid-market group accounts.
This position is responsible for working collaboratively with the other Managers and Sr. Director within underwriting to develop, implement and maintain procedures that adhere to the insurance regulations as they pertain to financial controls.
ESSENTIAL DUTIES AND RESPONSIBILITIES may include, but are not limited to, the following:
Duties and Responsibilities
1. Provides management and account level guidance to 5-10 underwriters, with direct responsibility for staff hiring, auditing, staff performance and specific resource needs. Operates within budget constraints and participates in tactical and strategic planning.
2. Support attainment of corporate sales and profitability goals through the oversight of the teams analysis of critical variables (e.g. demographics, claims experience, benefit levels, contribution strategy, carrier history, etc.) and the development of appropriate new business rates. He/she may apply underwriting judgment to deviate from standard risk analysis methodologies, policies, procedures, and funding arrangements. Attends meetings with prospective clients along with sales representatives to assist with the explanation and negotiation process. Prepares and/or reviews Underwriting Department responses to financial sections of Requests for Proposals (RFPs).
3. Directly responsible for working with their team to ensure the retention and profitability of existing business through the calculation of appropriate renewal rates. Ensuring the underwriter utilizes all currently available information, factors and formulae to accurately predict future claims and non-claims expenses. Ensure the underwriters work closely with the assigned Account Manager to provide alternate benefit plans, risk and/or funding arrangements and upon notification of renewal acceptance, update appropriate billing rate files, contracts, internal databases, etc.
4. Monitor financial performance of assigned book of business to provide advance notice of potential adverse outcomes to Underwriting Department Senior Leadership. Provide technical expertise and support to the segment Sales Directors regarding potential benefit changes and/or alternatives available to the account. Ensure account performance is accurately reflected on corporate financial statements and forecasts.
5. Provide support to Sales and Account Management staff on Underwriting related issues. Communicate and negotiate directly with prospects, existing accounts, brokers and consultants in order to explain and justify CareFirst Underwriting principles and procedures. Serve as a company wide reference and represent the Underwriting Department on cross-functional teams as necessary. Provide support to Finance, Legal, Operations, etc. as requested.
6. Provide training support, mentoring, coaching and guidance to underwriting staff. Utilizes knowledge of products, legislation and CareFirst competitors to enhance the development and performance of underwriting associates. Reviews work in order to ensure accuracy, quality, and compliance with corporate and departmental policies.
7. Develops, maintains, 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.
This position requires a minimum of five (5) to seven (7) years of progressively responsible group underwriting experience, including both indemnity and managed care products. Bachelors Degree in Business, Accounting, Finance or related field or equivalent experience is required. It is preferred that the individual possesses a Master’s Degree in a related field. Two (2) years prior supervisory, management or related experience leading teams or projects is preferred.
Individual must be extremely knowledgeable of risk evaluation and pricing methodologies used within the health insurance industry and at CareFirst. Thorough 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 extensive corporate knowledge. Position requires excellent written and oral communication skills, including the ability to explain complex topics clearly to diverse and potentially hostile audiences.
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
Administration of Large Group
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/careers
Please apply before:
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.
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 Sponsorship