Job Abstract

Evaluates standard and nonstandard data to understand premium, claim, exposure, and population. Works with team to identify actionable data insights/irregularities and research solutions. With general direction, uses and documents models, tools, and assumptions that support business strategy analysis and risk management. Supports the implementation of quality and process improvement efforts. Works in support of department initiatives, program, and enterprise goals. With limited guidance, assesse... more details

Description:
Evaluates standard and nonstandard data to understand premium, claim, exposure, and population. Works with team to identify actionable data insights/irregularities and research solutions. With general direction, uses and documents models, tools, and assumptions that support business strategy analysis and risk management. Supports the implementation of quality and process improvement efforts. Works in support of department initiatives, program, and enterprise goals. With limited guidance, assesses risk of accounts. Leverages comprehensive knowledge of the external business environment. With limited guidance, presents renewal recommendations to clients/organization. With guidance as needed, collaborates internally to develop case/investment strategies. Follows protocols to develop rates and account plans that mitigate risk. Contributes to rate negotiations with external parties. Begins to interact with customers to ensure external understanding of underwriting approach. Helps address data needs and requests. Builds relationships with customers and channel partners. With some guidance, works with internal partners to bring financial solutions to customers. Provides and leverages self/peer review of own work. Maintains compliance with relevant policies, guidelines, and procedures.

• Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome.


• Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or sponsorship. Collaborates with others to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports the completion of priorities, deadlines, and expectations. Identifies and speaks up for ways to address improvement opportunities.


• Analyzes and reports on data by: evaluating standard and nonstandard data to understand premium, claim, exposure, and inform understanding of population risk, with limited guidance; developing a working understanding of how to evaluate credibility, utilization, and risk based on population size and prior predictive behavior of the pool/account; working with team to identify actionable insights and potential data irregularities and research solutions; with general direction, using models (e.g., rate models and benefit pricing tools) and data analytics tools that support the analysis of business strategy and financial/underwriting risk management; and consistently documenting models, tools, assumptions, and data elements for increasingly complex accounts, as required.


• Completes case and underwriting work by: processing account activities (e.g., running reports, re-quotes, investments, sold rates) for customers and/or book of business under moderate direction; in collaboration with internal departments, following established methodologies and protocols to develop rates that appropriately mitigate risk for the organization and optimize sustainable membership growth; contributing to the execution of an account plan that addresses threats and opportunities to ensure attainment of goals in collaboration with Sales and Account Management; exercising judgment when contributing to rate negotiations with external parties (e.g., brokers, consultants, and customers); and, with some guidance, representing Underwriting in partnership with internal and external partners to co-create effective consultative solutions (e.g., case strategy, investment strategy, benefits strategy).


• Contributes to case review and preparation by: conducting account risk assessment using competitive analyses, broker behavior, network cost profiles, legislative and regulatory impacts, revenue requirements, and contributions, with limited guidance, especially when working on complex cases; utilizing data and standardized tools to present underwriting and renewal actions and recommendations (e.g., rate drivers, potential risk, glide path, membership impact, projections for future) to clients and/or the organization, with limited guidance; developing and applying a comprehensive knowledge of the external business environment and how it applies to the line of business and/or region; and collaborating with Sales and Account Management to develop case/investment strategies and recommendations with appropriate documentation with guidance, as needed.


• Engages with the external market by: beginning to independently interact with external market to help the market/customers understand the underwriting approach (e.g., rating methodology, rate drivers, reporting capabilities, and uniqueness from fee for service carriers); helping address data needs and requests reactively and proactively, as they arise; building relationships with customers and channel partners that enable them to understand KPs value; and, with some guidance, collaborating with account management and sales partners to bring strategic, financial solutions to customers, communicate product capabilities, explain funding arrangements, and negotiate conditions of offering and pricing within the limits of their authority.


• Contributes to goals, initiatives, and program development efforts by: supporting the implementation of innovative new quality and process improvement efforts with general instructions; and executing their work in support of department initiatives, program goals, and enterprise goals.


• Ensures compliance of Underwriting work by: incorporating feedback from peer reviews of own work to ensure accuracy and appropriateness of quotes, providing self/peer review as required; appropriately obtaining and documenting case approvals and any policy exceptions and investments; making investment decisions within their authority and escalating to the appropriate level, as needed; and maintaining awareness of and compliance with all relevant policies, guidelines, and procedures, applying them to their own work.