Director, Rating and Underwriting

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.

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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Full-Time

Competitive Compensation and Benefits Package

Overview: <span style="font-family: arial, sans-serif; font-size: small;">Responsible for a multi-billion dollar book of business working with Underwriting, Actuarial, Finance, and Business Segment executive leadership to determine the financial and business targets of the company and ensuring the execution of work within the assigned department to meets those targets. Plan, forecast, monitor and evaluate department/corporate goals and objectives relating to group rating and underwriting, staff training, workflows, and operational procedures.</span>
Responsibilities: <ul style="font-weight: 400;"> <li>Manage a multi-billion-dollar portfolio of business spanning multiple segments minimizing adverse selection through case positioning and consultation with brokers, agents, vendors, consultants, sales and customers to meet profitability targets.&nbsp;&nbsp;</li> <li>Serve as key negotiator for rates and contracts on assigned accounts to ensure BCBSM/BCN profitability targets are met and coordinate activities with regard to product and pricing strategies and their financial impact on customers.&nbsp;</li> <li>Lead assigned area in the utilization of a consultative approach to analyze customer claim and demographic data, review requests for customized rating arrangements and make recommendations on the final rates, administrative costs and any benefit plan design changes to meet the needs of current and prospective customers.&nbsp;</li> <li>Provide leadership and analysis on BCBSM and BCN&rsquo;s value proposition (how our products add value to the customer) to internal and external stakeholders and partner with the business segments to meet corporate underwriting financial goals and associated P&amp;L objectives through risk assessment to safeguard the financial assets of the company.</li> <li>Support BCBSM &amp; BCN senior leadership by providing efficient and effective solutions to complex business problems. Utilizing collaboration and influence to provide special analysis or adhoc reports to various internal committees, presentation of findings and recommendations that improve financial health and segment growth and continuously monitor the regulatory and competitive environment to ensure implementation of necessary changes.&nbsp;</li> <li>Develop short and long term goals for the assigned business units to realize corporate, divisional and departmental objectives. Implement programs and action plans to achieve those goals ensuring continuous improvement.</li> <li>Direct staff of assigned Underwriting department. This includes supervising, training and development. Maintain team member motivation. Responsible for staff selection, performance evaluation, coaching, and discipline.&nbsp;</li> <li>Develop and maintain a presence with key customers and interdependent areas to explain rate increases, implement changes in rating methodologies, and improve general business processes.&nbsp;</li> <li>Other duties as assigned.&nbsp;</li> </ul>
Requirements: <ul style="font-weight: 400;"> <li>Bachelor's Degree in related field required. Master's Degree preferred.</li> <li>Eight (8) years of experience in rating and underwriting required.</li> <li>Five (5) years of supervisory experience required.</li> <li>Significant experience with Actuarial and group insurance principles, health care benefits and claims processing procedures, rating formulas, self-funded and alternative financial arrangements.</li> <li>Excellent analytical, organizational, planning and problem-solving skills with an ability to handle multiple tasks.</li> <li>Excellent verbal and written communication skills required including the ability to present to executive leadership and external customers.</li> <li>Excellent interpersonal, consultative and negotiation skills to interface with major account, union, internal support areas, or external organizations involved in servicing the account and positioning cases using sound business information.</li> <li>Ability to apply an understanding of the competitive landscape to rating decisions and recommendations and teach it to team members.</li> <li>Ability to work effectively in a team environment.</li> <li>Ability to recognize and handle customer-sensitive situations.</li> <li>Ability to collaborate cross-functionally to achieve enterprise objectives.</li> <li>Ability to demonstrate flexibility and adaptability to manage ambiguity in a dynamic and changing environment.</li> <li>Ability to stay informed and educate staff on federal and state laws and regulations related to health care delivery systems (HMO, PPO, ACO, etc.) and sales distribution channels required.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <p style="font-weight: 400;"><strong>CERTIFICATES, LICENSES, REGISTRATIONS</strong></p> <p style="font-weight: 400;">If an employee is selling/negotiating a price as part of the duties and responsibilities of this job, the following licenses are required within 90 days of the employee's start date or license expiration date.</p> <ol style="font-weight: 400;"> <li>Valid Michigan Accident and Health Insurance License</li> <li>Valid and unrestricted driver's license is required</li> </ol>