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Translate and interpret large group claim information competitor data analysis prognosis and clinical data to determine the most appropriate premium for the large group customers. Deliver an integrated renewal package and provide consultative expertise to our large group sales staff and external stakeholders including brokers groups and consultants. Participate in process initiatives and/or projects that offer continuous improvement to both our internal and external stakeholders by focusing on the customer and understanding the business to support financial initiatives corporate goals and strategies.
Qualifications :
Required:
Additional Information :
a. Translate and interpret financial and medical data from a wide variety of sources and formats including competitor information to compile categorize and summarize information such as trends and costs utilizations loss ratios risk assessments industry variations.
b. Use statistical economic and financial data to perform standard financial risk analysis based on specific underwriting guidelines principles and procedures to set premiums for multiple funding arrangement options. Information evaluated includes trends claims experience ongoing large claimant information including diagnosis and prognosis group size and location information and the demographic makeup of a group based on age gender and type of contact.
c. Apply independent decision making skills based on mixture of expertise analysis and experience on variety of issues and requests including rating decisions. Decisions include identifying when appropriate escalation is needed and providing consultative recommendations for senior or leadership level direction/approval.
d. Use multitude of complex systems from various internal areas to obtain and organize data while using department rating systems to evaluate current performance and project future trends of a group. Demonstrate high level of communication skills to document rating decisions with detailed rationale.
e. Represent Wellmark and Underwriting through the support of the Sales areas in their interactions with external customers. (accompanied by leadership or senior level). This includes participating in various communication opportunities on a ongoing or adhoc basis. Serve as an department interface with both internal and external stakeholders and work to build and maintain constructive and cooperative relationships based on trust.
f. Build and maintain general understanding of insurance industry market segments and operations in order to evaluate group and benefit requests to ensure compliance with federal state corporate and department laws regulations and guidelines. Work to create internal control mechanisms.
g. Participate and serve as subject matter expert on interdepartment or on crossdivisional teams on complex projects relating directly or indirectly to underwriting process procedures and/or guidelines. Support projects in order to meet deadlines and deliver desired results.
h. Actively participate in corporate process improvement initiatives and activities aimed at reducing cost improving timeliness and accuracy while enhancing the overall customer experience. Develop update and maintain documentation on key processes and department guidelines.
i. Manage multitude of daily desk responsibilities monthly department duties and project deliverables to meet deadlines. Balance high priority requests with short turnaround timeframes to meet requests of ever changing needs of our groups.
j. Other duties assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit hire train and promote individuals in all job classifications without regard to race color religion sex national origin age veteran status disability sexual orientation gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at
Please inform us if you meet the definition of a Covered DoD official.
Remote Work :
No
Employment Type :
Fulltime
Full-time