EmblemHealth
Location: New York,NY, USA
Date: 2024-12-24T20:44:08Z
Job Description:
Summary:
- Underwrite EmblemHealth's existing and new business accounts, including Broker Accounts within published time frames.
- Process sold new business groups.
- Maintain logs and complete various reports as needed.
Responsibilities:
- Underwrite new and existing large groups, within the published departmental time frames, and using the departmental and corporate guidelines, strategies and goals.
- Evaluate risk using demographics, claims experience, predictive modeling, high-cost claimant review, and other criteria.
- Utilize various pricing models to develop both manual and experience rates.
- Provide clear documentation and recommendations to management.
- Update tracking tools. Evaluate pricing impact of alternative plan designs.
- Review and analyze Request for Proposals (RFPs) and prospective and renewal rate quotes from Brokers, Consultants, and Marketing Representatives.
- Collect data and produce enrollment, claims, utilization reports from COGNOS, Tableau, Facets and other databases/reporting tools.
- Communicate and explain Underwriting recommendations/decisions to the Sales Account Executives.
- Prepare summaries for Account Executives for renewals, based on financial history of the groups, demographics and projections moving forward.
- Provide support explaining analysis to brokers and/or customers as needed.
- Perform other duties as assigned or required.
Requirements:
- Bachelor's degree in Mathematics, Economics, Statistics, Finance or Business Administration required
- 2 - 3+ years of relevant, professional work experience required
- 2 - 3+ years of Group Health Insurance Underwriting experience required
- Knowledge of underwriting methodologies including Experience Rating Methodology required
- Strong communications skills (verbal, written, presentation, interpersonal) with all types/levels of audience required
- Proficiency with MS Office (Word, Excel, PowerPoint, Outlook, Teams) required