Job Description

Company :

Highmark Inc.

This job analyzes risk factors for new enrollment, annual renewals, and amendments of insurance contracts or self-funded plans in conformance with established underwriting policies, practices, and standards. This role serves as a point of contact for sales teams and assigned customers, delivering insights and recommendations to aid customer acquisition andretention while maintaining performance goals. This role analyzes data such as type of industry, financial condition, and other characteristics to assess risk for a book of business consisting of standard small and mid-sized clients.

ESSENTIAL RESPONSIBILITIES

• Work with sales team and underwriting peers and leaders to manage a portfolio of clients towards financial and business targets (e.g., membership, revenue, margin).

• Under supervision, serve as owner of all quotes delivered to sales partners. Develop a perspective on each client package deliverable. Clearly communicate position on the risk profile of each client.

• Respond to questions and draw insights from quote details, client understanding, and regional insights to deliver recommendations to sales, under supervision.

• Calculate rates utilizing company rating algorithms, under supervision.

• Identify unusual situations not anticipated by standard pricing formulae and seek assistance in applying Corporate Risk Management policies.

• Interpret risk and apply pricing policies to account for unusual situations. Identify questionable claim patterns whether occurring on an in-force account or a prospect.

• Maintain accurate book management details, including concession budget.

• Assess risk by looking at various measures such as risk scores, demographic analysis, and turnover considerations, under supervision.

• Develop a basic understanding of the department and the company strategic goals and competitive position.

• Communicate case-specific underwriting results with other internal departments under supervision.

• Complete workload within established production and timeliness standards.

• Perform administrative tasks and aid in workload coordination.

• Other duties as assigned.

EXPERIENCE
Required

• None

Preferred

• 1 year of relevant underwriting, risk management, or actuary experience applying advanced mathematics or quantitative analysis.

SKILLS

• Ability to use computer systems, electronic tools, and applications

• Ability to manage several simultaneous priorities

• Demonstration of ethical business practices with adherence to guidelines

• Strong attention to detail

• Basic analytical skills

EDUCATION
Required

• Bachelor's degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, Science, Technology, or other quantitative analysis discipline or relevant experience as determined by the company in lieu of a b achelor’s degree.

Preferred

• None

LICENSES or CERTIFICATIONS
Required

• None

Preferred

• None

Language (Other than English)

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Non - Office based position

Teaches / trains others

Rarely

Travel from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance RequirementThis job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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