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

keywords: planning,compliance,business development,management,develop,performance,provide,teamwork,consulting,leadership,experience,skills,teamwork,degree,compliance,communication

Full-Time

Competitive Compensation and Benefits Package

Overview: Responsible for a multi-billion dollar book of business working with BCBSM Segments, BCN &amp; Actuarial &amp; Underwriting Vice Presidents to determine the financial and business targets of the company and ensure the execution of work within assigned department meets those targets. Plan, forecast, monitor and evaluate department/corporate goals and objectives relating to rate filings, group rating &amp; underwriting, staff training, workflows, and operational procedures. Responsible for ensuring compliance with all regulatory agencies regarding rate methodologies.
Responsibilities: <ul> <li><span style="font-size: small;">Manage multi-billion-dollar portfolio of business spanning multiple segments minimizing adverse selection through case positioning consulting with Brokers, Agents, Vendors, Consultants, Sales, and customers to meet profitability targets.&nbsp;&nbsp;</span></li> <li><span style="font-size: small;">Serve as key negotiator for rates and contracts on assigned accounts to ensure BCBSM/BCN profitability targets are met and coordinate activities between Segments and BCN with regard to product and pricing strategies financial impact to customers.&nbsp;</span></li> <li><span style="font-size: small;">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;</span></li> <li><span style="font-size: small;">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.</span></li> <li><span style="font-size: small;">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;</span></li> <li><span style="font-size: small;">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.</span></li> <li><span style="font-size: small;">Direct staff of assigned Rating &amp; Underwriting department. This includes supervising, traini</span><span style="font-size: small;">ng and development. Maintain team member motivation. Responsible for staff selection, performance evaluation, coaching, and discipline.&nbsp;</span></li> <li><span style="font-size: small;">Develop and maintain a presence with key customers and interdependent areas to explain rate increases, changes in rate methodologies, manage work on health care exchange, improve business processes.&nbsp;</span></li> <li><span style="font-size: small;">Other duties as assigned.&nbsp;</span></li> </ul>
Requirements: <ul> <li><span style="font-size: small;">Bachelor's Degree in related field required. Master's Degree preferred.</span></li> <li><span style="font-size: small;">Eight (8) years of experience in rating and underwriting required.</span></li> <li><span style="font-size: small;">Five (5) years of supervisory experience required.</span></li> <li><span style="font-size: small;">Significant 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.</span></li> <li><span style="font-size: small;">Excellent analytical, organizational, planning and problem solving skills with an ability to handle multiple tasks.</span></li> <li><span style="font-size: small;">Excellent verbal and written communication skills required including the ability to present to executive leadership and external customers.</span></li> <li><span style="font-size: small;">Excellent interpersonal, consultative and negotiations 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.</span></li> <li><span style="font-size: small;">Ability to apply understanding of competitive landscape to rating decisions and recommendations and teach it to team members.</span></li> <li><span style="font-size: small;">Ability to work effectively in a team environment.</span></li> <li><span style="font-size: small;">Ability to recognize and handle customer sensitive situations.</span></li> <li><span style="font-size: small;">Ability to collaborate cross functionally to achieve enterprise objectives.</span></li> <li><span style="font-size: small;">Ability to demonstrate flexibility and adaptability to manage ambiguity in a dynamic and changing environment.</span></li> <li><span style="font-size: small;">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.</span></li> <li><span style="font-size: small;">Other related skills and/or abilities may be required to perform this job.</span></li> </ul> <div><strong><span style="font-size: small;">CERTIFICATES, LICENSES, REGISTRATIONS</span></strong></div> <div><span style="font-size: small;">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.</span></div> <ol> <li> <div><span style="font-size: small;">Valid Michigan Accident and Health Insurance License</span></div> </li> <li> <div><span style="font-size: small;">Valid and unrestricted driver's license is required</span></div> </li> </ol>