The Core Manager – Operations is responsible for overseeing three key areas in Core Underwriting – Audit, Packaging, and Small Group Business. This team is the operational and logistic center of the Core Team and is considered the backbone of the group.
The Audit Team will be responsible for supporting any external audits from institutions like the PA Insurance Department, supporting internal Highmark audits like MAR, and managing and handling UW audits like Rate Cap contract and benefit reviews.
The Packaging Team will be responsible for some of the operational and logistic aspects of Core processing such as loading rates into ICIS, distributing renewals to Sales via SFA, and file maintenance and folder prep.
The Small Group Team will be responsible for handling any small group business needs like reviewing the ATNE and UQs to recommend appropriate pricing segment for clients and managing the medically screened applications before passing along to Medical Underwriters for assessment.
Essential Job Functions:
- Behave in a manner that exhibits the company's core values. Support, interpret, and promote adherence to departmental and company goals, strategies, policies, procedures and norms. Manage and develop employees by setting clear, concise performance expectations, monitoring progress, providing constructive feedback and creating an environment that encourages ongoing growth. Complete performance planning and evaluations in a timely manner. Manage own activities and others to accomplish assigned goals and objectives within agreed upon time constraints. Develop sound strategies that create a line of sight from individual to department to company goals and objectives.
- Reviews renewal and prospect quotes to provide guidance as to whether results are reasonable and appropriate.Recommend modifications to situations that will result in adverse selection and subsequent financial loss.
- Demonstrate an expert understanding of the contents and intent of corporate risk management policies. Identify critical information needs in risk management negotiations and modify arrangements based on the information available. Discuss alternative risk management and pricing methods in use by others in the industry and provide advantages and disadvantages to each method.
- Oversee production to ensure timely and accurate completion of renewals and prospect quotes.
- Develop relationships with decision makers based on trust and credibility to enhance influence on risk management and pricing decisions. Provide solid and persuasive arguments to move Sales and external audiences toward appropriate risk solutions. Enhance department influence by negotiating workable solutions, meeting deadlines and providing responsive service.
- Lead departmental efforts in areas such as, but not limited to, pricing policy, departmental policies and procedures, product development, interdepartmental processes or corporate projects. Oversee departmental tools and processes such as, but not limited to, training, testing, reporting and process improvement. Support all audit and market conduct reviews in order to maintain compliant rates, controls and processes.
- Other duties as assigned or requested.
- Bachelor Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, Nursing, Healthcare Administration or other quantitative analysis discipline (6 years of related experience may be substituted in lieu of degree)
- 8 years of experience in underwriting or actuarial
- 12 years of experience in underwriting
- Producer's License in Accident and Health or a willingness to pursue and obtain a Producer's License within six months
- Possesses or is willing to obtain within two years, a professional designation related to the health care industry (i.e. HIAA/AMHC, CEBS, SOA) or a Licensed Registered Nurse without restriction
- Ongoing compliance with all requirements to keep all licenses and professional designations