Job Abstract

Evaluates moderately complex data to understand premium, claim, exposure, and population. Identifies and escalates actionable data insights/irregularities, recommending solutions. Creates/uses/documents models, tools, and assumptions that support business strategy analysis and risk management. Making recommendations to improve the implementation of quality and process improvement efforts. Works in support of department initiatives, program, and enterprise goals. Independently assesses risk of accounts. Leverages advanced knowledge of the external business environment. With guidance as needed, presents renewal recommendations to clients/organization. Collaborates internally to develop case/investment strategies. Drives the development of rates and account plans that mitigate risk. Negotiates rates with external parties. Helps moderately complex customers understand underwriting approach. Addresses complex data needs and requests. Builds relationships and influences outcomes with customers and channel partners. Works with internal partners to bring financial solutions to increasingly complex customers. Provides self/peer review of complex cases. Maintains compliance with relevant policies, guidelines, and procedures.

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.


• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.


• Analyzes and reports on data by: evaluating moderately complex data to understand premium, claim, exposure, and inform understanding of population risk; applying advanced knowledge to evaluate credibility, utilization, and risk based on population size and prior predictive behavior of the pool/account; identifying and escalating actionable insights and potential data irregularities and recommending solutions; determining and executing on the best course of action for creating and 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: independently processing renewal activities (e.g., running reports, re-quotes, investments, sold rates) for customers and/or book of business; in collaboration with internal departments, driving the development of rates that appropriately mitigate risk for the organization and optimize sustainable membership growth; exercising judgment and discretion when developing and executing an account plan that addresses threats and opportunities to ensure attainment of goals in collaboration with Sales and Account Management; negotiating rates with external parties (e.g., brokers, consultants, and customers); and 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: independently conducting account risk assessment using competitive analyses, broker behavior, network cost profiles, legislative and regulatory impacts, revenue requirements, and contributions, with guidance as needed, 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 guidance as needed; developing, applying, and expanding advanced 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.


• Engages with the external market by: helping moderately complex market/customers understand the underwriting approach (e.g., rating methodology, rate drivers, reporting capabilities, and uniqueness from fee for service carriers); addressing complex data needs and requests reactively and proactively, as they arise; building relationships and influencing outcomes with customers and channel partners that enable them to understand KPs value; and 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 for increasingly complex accounts.


• Contributes to goals, initiatives, and program development efforts by: making recommendations to address issues in implementation of innovative new quality and process improvement efforts; and executing their work in support of department initiatives, program goals, and enterprise goals.


• Ensures compliance of Underwriting work by: providing self/peer review of complex cases, as required, to ensure accuracy and appropriateness of quotes and incorporating feedback from others; 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.