Resp & Qualifications

PURPOSE:

Responsible for evaluating applicant situation and circumstances; studying rate tables, codes, computer records and references, and other resources; calculating premium rates; negotiating reinsurance terms; describing insurable conditions; specifying exclusions and endorsements; obtaining second signatures; denying policies. Medical Underwriters - Responsible for recommending and applying medical underwriting guidelines and working with the departmental trainer to educate the underwriting teams. The incumbent understands the difference between clinical prognosis and future financial risk.

ESSENTIAL FUNCTIONS:

• Ensure the retention and profitability of existing business through the calculation of appropriate renewal rates. 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. Update appropriate billing rate files, contracts, internal databases, etc. 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. Participate and have an active role in department special projects, while embracing change in a positive manner. Provide guidance and assistance to junior level staff.

• 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: Complete complex Demographically Rated and Experience Rate quotes. Complete Stop Loss and ASO quotes. Responsible for applying underwriting judgment and preparing RFP responses. Meeting the stated close ratio goals, average turnaround time goals. Providing clear documentation and file maintenance. Using the latest actuarial tables and factors.

• 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.

• 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: Communicating and negotiating directly with prospects, existing accounts, brokers & consultants. Represents the Underwriting department in meetings with prospects, existing accounts, brokers & consultants.

• 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: Participation in internal and external courses. Providing Training Support, Mentoring and Coaching to junior underwriters. Continuing to improve computer skills.

SUPERVISORY RESPONSIBILITY:

Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.

QUALIFICATIONS:

Education Level: Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 5 years underwriting experience in group health, medical, ancillary benefits and/or pharmacy.

Knowledge, Skills and Abilities (KSAs)

Knowledge of insurance underwriting methods and procedures.

Excellent communication skills both written and verbal.

Skill in interviewing techniques.

Ability to maintain effective interpersonal relationships.

Self-starter with an ability to work under minimal supervision.

Licenses/Certifications :

• Associate in Personal Insurance, Commercial Underwriter Upon Hire

• Chartered Life Underwriter

Salary Range: $70,488 - $139,997

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Pharmacy Underwriting

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.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

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 Sponsorship.

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REQNUMBER: 19699