Rating and Underwriting Consultant

<p>With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.</p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

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Competitive Total Compensation Package

Overview: <strong>Evaluate and assess risks to safeguard the financial assets of the company. Coordinate and direct highly complex and specialized Underwriting projects, which have significant impact on the company&rsquo;s financial position and other functional areas. Responsible for financial soundness of rates and prices for a significant line of business.</strong>
Responsibilities: <ul> <li>Lead, facilitate, direct and coordinate the production of renewal rates or new business proposals, cost estimates for benefit modifications and various coordinating reports. Manage and communicate results of renewal and quote adequacy monthly meetings.&nbsp;</li> <li>Assess, approve, reject or make recommendations for complex underwriting rating policy exception requests taking into consideration financial and operational impact.&nbsp;</li> <li>Initiate and maintain appropriate rating and underwriting policies, procedures, documentation and audit readiness to comply with state and federal requirements.&nbsp;</li> <li>Ensure application of underwriting practices and processes including risk management, differences in insured vs ASC programs, managing stop-loss, demographic rating vs claims rating.&nbsp;</li> <li>Proactively seek out opportunities to develop new systems, solutions, enhancements to better manage reporting capabilities for financial forecasting, membership and performance metric reporting.&nbsp;&nbsp;</li> <li>Independently communicate rating and underwriting issues, solutions, risks, implications, impacts of financials / membership results and recommendations on behalf of the department and division to team members, senior leadership, internal and external stakeholders.&nbsp;</li> <li>Lead, plan and deliver projects utilizing project management methodology to enhance systems, business processes, procedures and reporting, coordinating across departments and divisions.&nbsp;&nbsp;Act as a technical resource and subject matter expert to address or resolve underwriting and healthcare issues across the enterprise and review work of peers for underwriting accuracy and compliance representing the organization on industry task forces and work groups when necessary.&nbsp;</li> <li>Other duties as assigned.</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in Mathematics, Statistics, Finance, Accounting, Economics, or related field required. Master's Degree preferred.</li> <li>Six (6) years&rsquo; experience in rating/underwriting or related field with two (2) years at a Senior Underwriter.</li> <li>Experience with actuarial and group insurance principles, health care benefits and claims processing procedures, rating formulas, self funded and alternative financial arrangements, and the systems and mainframe applications.</li> <li>Ability to participate in multifunctional workgroups as SME or Business Lead</li> <li>Ability to analyze financial data, draw valid conclusions, suggest reasonable solutions and prepare summary reports required.</li> <li>Strong understanding of mathematics principals and their practical applications required.</li> <li>Excellent verbal and written communication skills required including the ability to present to executive leadership and external customers.</li> <li>Ability to function independently under minimal supervision adjusting effectively to changes in work and keeping an open mind to new and better ways of accomplishing results.</li> <li>Knowledge of Microsoft Excel, Word and PowerPoint required.MS Access &amp; Visual Basic required.</li> <li>Ability to maintain knowledge of Federal and State laws and regulations related to health care delivery systems (HMO, PPO, ACO, etc.) and sales distribution channels required.</li> <li>Good organizational and time management skills with an ability to handle multiple tasks.</li> <li>Strong understanding of national &amp; local competitive landscape and apply it to rating decisions and consultative analysis.</li> </ul>