Associate Medical Stop Loss Underwriter
Highmark Health, Montpelier, VT, United States
Job Summary
This role involves pricing quotes and analyzing the structure of group contracts based on claims experience, employee group characteristics, and other factors. The incumbent will exercise discretion under underwriting authority within HMIG policies to ensure profitable and growth-oriented outcomes. Responsibilities include assessing risk factors for new enrollments, renewals, and amendments, reviewing policies and market data for continuous improvement, and preparing reports to support underwriting decisions and rate calculations.
Essential Responsibilities
Manage a book of renewing accounts and write new business at profitable levels to meet HMIG business targets.
Utilize systems and tools to gather data and accurately complete and track assigned work.
Complete rating and analysis work with guidance from senior staff.
Calculate rates, employ various financial arrangements, interpret pricing policy, and adapt to unusual situations.
Identify questionable claim patterns and recommend adjustments based on competitor data.
Apply corporate risk management policies and adjust when standard pricing formulas may not address specific risks.
Flag clients who do not comply with risk management policies, disclosure rules, or enrollment criteria.
Recommend appropriate pricing adaptations for client-specific situations.
Engage internal departments to manage member risk.
Support internal initiatives such as fraud detection, corporate compliance, wellness programs, and product development.
Complete renewals and prospect quotes per production and timeliness standards.
Adapt to changing priorities as new quotes arrive from varied markets.
Communicate policy adaptation recommendations with clear rationale.
Influence sales and external audiences toward suitable risk solutions and pricing structures.
Perform additional duties as assigned or requested.
Education
Required
Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, or another quantitative analysis discipline.
Substitutions
Six years relevant, progressive experience in the area of specialization.
Preferred
None.
Experience
Minimum
0–2 years of experience in insurance underwriting of self‑funded or fully insured prospects.
Preferred
None.
Skills
Understand internal departments and interact with external stakeholders.
Use applicable computer systems, electronic tools, and applications.
Work independently and assume responsibility for routine projects.
Support corporate and departmental goals and initiatives.
Adhere to privacy and confidentiality policies and regulations.
Apply analytical, organizational, and negotiation skills.
Demonstrate strong math aptitude for quantitative analysis.
Required Licensure
None.
Preferred Licensure
Actively pursuing a professional designation related to healthcare and willing to complete a course within twelve months (e.g., LOMA CEBS or AHIP).
Travel Requirement
0%–25%
Physical, Mental Demands and Working Conditions
Position Type: Office‑based
Teaches / trains others regularly: Occasionally
Travel from the office to various work sites: Rarely
Works primarily out‑of‑the‑office selling products/services: Never
Physical work site required: Yes
Lifting: up to 10 pounds: Constantly
Lifting: 10–25 pounds: Occasionally
Lifting: 25–50 pounds: Rarely
EEO Statement
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on veteran or disability status and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
Pay Range Minimum
$23.16
Pay Range Maximum
$35.88
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This role involves pricing quotes and analyzing the structure of group contracts based on claims experience, employee group characteristics, and other factors. The incumbent will exercise discretion under underwriting authority within HMIG policies to ensure profitable and growth-oriented outcomes. Responsibilities include assessing risk factors for new enrollments, renewals, and amendments, reviewing policies and market data for continuous improvement, and preparing reports to support underwriting decisions and rate calculations.
Essential Responsibilities
Manage a book of renewing accounts and write new business at profitable levels to meet HMIG business targets.
Utilize systems and tools to gather data and accurately complete and track assigned work.
Complete rating and analysis work with guidance from senior staff.
Calculate rates, employ various financial arrangements, interpret pricing policy, and adapt to unusual situations.
Identify questionable claim patterns and recommend adjustments based on competitor data.
Apply corporate risk management policies and adjust when standard pricing formulas may not address specific risks.
Flag clients who do not comply with risk management policies, disclosure rules, or enrollment criteria.
Recommend appropriate pricing adaptations for client-specific situations.
Engage internal departments to manage member risk.
Support internal initiatives such as fraud detection, corporate compliance, wellness programs, and product development.
Complete renewals and prospect quotes per production and timeliness standards.
Adapt to changing priorities as new quotes arrive from varied markets.
Communicate policy adaptation recommendations with clear rationale.
Influence sales and external audiences toward suitable risk solutions and pricing structures.
Perform additional duties as assigned or requested.
Education
Required
Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, or another quantitative analysis discipline.
Substitutions
Six years relevant, progressive experience in the area of specialization.
Preferred
None.
Experience
Minimum
0–2 years of experience in insurance underwriting of self‑funded or fully insured prospects.
Preferred
None.
Skills
Understand internal departments and interact with external stakeholders.
Use applicable computer systems, electronic tools, and applications.
Work independently and assume responsibility for routine projects.
Support corporate and departmental goals and initiatives.
Adhere to privacy and confidentiality policies and regulations.
Apply analytical, organizational, and negotiation skills.
Demonstrate strong math aptitude for quantitative analysis.
Required Licensure
None.
Preferred Licensure
Actively pursuing a professional designation related to healthcare and willing to complete a course within twelve months (e.g., LOMA CEBS or AHIP).
Travel Requirement
0%–25%
Physical, Mental Demands and Working Conditions
Position Type: Office‑based
Teaches / trains others regularly: Occasionally
Travel from the office to various work sites: Rarely
Works primarily out‑of‑the‑office selling products/services: Never
Physical work site required: Yes
Lifting: up to 10 pounds: Constantly
Lifting: 10–25 pounds: Occasionally
Lifting: 25–50 pounds: Rarely
EEO Statement
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on veteran or disability status and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
Pay Range Minimum
$23.16
Pay Range Maximum
$35.88
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