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POST DATE 10/11/2017
END DATE 12/9/2017
Blue Cross and Blue Shield of North Carolina
JOB DESCRIPTIONJOB DESCRIPTION
The purpose of this position is to manage the relationships of our larger and more complex group customers. These customers expect and demand an extremely high level of customized service. The person in this position must be comfortable making million dollar decisions and communicating these decisions to various C-level executives and others. These decisions are hallmarked by complex risk assumption and mitigation strategies as well as financial modeling strategies. This position is expected to meet all Business Segment goals related to revenue, margin and membership.
* Manages Books of Business with up to 250,000 members and representing up to $750,000,000 in premium or premium equivalent.
* Application of data analytics across book of business to identify trends or patterns and take corrective action as required.
* Coach underwriters that are below the Underwriting Consultant level on matters related to risk selection and mitigation, data analytics and integrated goal management.
* Has the authority to make exceptions to underwriting policy and recommendations to underwriters below the Underwriting Consultant level.
* Manages and reports out monthly and YTD on all assigned financial and performance metrics and provides as hoc reports as necessary.
* Develops and provides training to the underwriting staff, sales staff, and other departments in the principles and practices of underwriting and rating.
* Initiates underwriting process and system changes resulting in enhanced productivity.
* Participates in the Underwriting Department s strategic and tactical planning.
* Subject Matter Expert (SME) for the Department regarding their Business Segment and Corporate Projects.
* Represents Department in regards to NC DOI inquiries and audits, internal or external
* Analyzes underwriting risk and determines premium rates for fully insured contracts and recommends funding rates for Administrative Services Only (ASO) contracts.
* Proactively utilizes strong technical expertise to make recommendations regarding benefit plan design, stop loss levels, network feasibility and funding options to internal and external customers.
* Actively participates in final rate negotiations and presentations with our large clients.
* Bachelor s degree
* 5 years of underwriting experience.
* If no degree, 6 years of underwriting experience.
* Demonstrated negotiation experience with sales management and senior management at client companies and brokerage/consulting houses.
* Demonstrated ability to present alternate funding arrangements externally to brokers and customers.
* Experience leading large scale projects.
* Demonstrated ability in training and accurately reviewing work of less experienced team members, including the ability to sign off on appeal requests for less experienced Underwriters.
* Ability to present case-specific scenarios to senior management.
* Experience collaborating and building relationships with agents, brokers, consultants, group representatives and internal staff.
* Experience consulting with and advising senior and executive leadership.
* Expert level knowledge of Group health insurance industry (Federal & State) laws/regulations
* Strong negotiation and consultative skills.
* Significant knowledge of medical conditions and their impact on claims costs.
* Demonstrated experience with highly complex Group actuarial pricing, rating and underwriting methodologies
* Must have a high degree of competence with Microsoft Excel spreadsheets
* The ability to think critically, analyze highly complex data and have strong creative thinking and problem solving skills
* The ability to make sound decisions and/or recommendations based on analysis of complex data but also including some out of the box decisions/recommendations.
* HIA, RHU, CEBS, FAHM.