Healthcare Senior Underwriting Consultant at Kaiser Permanente

Posted in Other 11 days ago.

Type: Standard
Location: Oakland, California





Job Description:


Anticipate key business, marketplace and competitor dynamics in developing and implementing strategies to optimize business results which include retention and growth targets while mitigating risk. Primary focus is on establishing the appropriate rate and conditions of  offering to achieve revenue, membership and margin goals. Additionally, processes and policies are managed to support optimal customer service while collaborating with Sales/Account Management partners to optimize business opportunities and effective solutions.

Essential Functions:
- Partner with Sales and Account Management and other key internal stakeholders to create and execute a business plan that optimizes our opportunities across book of business.
- Produce accurate quotes in compliance with Underwriting and authority guidelines and state&federal laws for existing and prospective business.
- Develop and execute account and/or book of business plans to ensure attainment of goals primarily on complex cases.
- Lead peer review including the most complex cases to ensure accuracy&appropriateness of quote.
- Manage business processes and policies that support for all job levels particularly in areas of rate actions, benefit structure, customer engagements, etc.
- Meets established department turn around goals by balancing deadlines.
- Designs new and interpret existing policies, procedures, and methodology.
- Develop and leads in the implementation of continuous quality improvement programs.
- Strategically partner with&influence Actuarial Services and other internal customers to ensure KP business processes are in alignment with organizational and external customer goals when approppriate.
- Ensure Underwriting is an integral partner in the creation of effective business solutions.
- Establish and leverage relationships with Sales/Account Management and external customers that optimizes business potential with purchasers, brokers&consultants.
- Develop creative solutions that maximize credibility with customers&Sales/Account Management and external customers.
- Proactively acquire&exhibit knowledge of the external business environment to add value.
- Provide leadership to the team.
- Create and maintain positive, empowering work environment.
- Act as a role model.
- Coach and develop team members.



Basic Qualifications:
Experience
- Minimum seven (7) years of experience in rating, underwriting, marketplace evaluations, and/or financial analysis in a managed care environment.
Education
- Bachelor's degree required in business administration, health care administration, mathematics, statistics, OR four (4) years of experience rating, underwriting, marketplace evaluations, and/or financial analysis in a managed care environment.
License, Certification, Registration
- N/A.



Additional Requirements:
- Experience creating client presentations using Microsoft Office programs and use of client databases,
- Experience using effective verbal and written communication skills.
- Experience in interpersonal, presentation, and persuasion skills.
- Experienced in meeting individual business objectives.
- Previous experience with employee group benefits.
- Proficiency in computer and analytic skills.
- Proficiency and understanding of underwriting processes, healthcare products, and contracts.
- Demonstrated customer service skills with the ability to articulate and respond to highly complex issues.


 


Preferred Qualifications:
- Minimum eight (8) years of quantitative analysis experience preferred.
- Experience in Large Group Underwriting preferred.