Director Core Underwriting - Highmark Health
Pittsburgh, PA
About the Job
Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job is responsible for overseeing end-to-end operations of the designated function within Underwriting, including adherence to timeliness, quality expectations, and applicable internal and governmental regulations. The incumbent communicates daily within the function on work planning, risks, issues, etc and meets routinely with Underwriting leadership to review metrics, performance, and key issues.
ESSENTIAL RESPONSIBILITIES
+ Perform management responsibilities to include, but are limited to, involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
+ Plan, organize, staff and direct and control the day to day operations of the department, develop and implement policies and programs as necessary, may have budgetary responsibility.
+ Manage relationships between assigned function and other key stakeholders. Provide guidance to underwriting functions as a SME to health plan underwriting. Understand strategic and practical impacts of issues and voices concerns when necessary.
+ Ensure integrity and consistent application of Underwriting policies and guidelines for all clients.
+ In exception scenarios, 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.
+ Manage intraday workload planning across the function and escalates long-term concerns to appropriate inter-departmental team.
+ Other duties as assigned or requested.
EDUCATION
Required
+ Bachelor's Degree in Science, Mathematics, Technology or related field
Substitutions
+ 6 years of related underwriting experience in lieu of Bachelor degree
Preferred
+ None
EXPERIENCE
Required
+ 7 years of Health Care Underwriting
+ 5 years in a Leadership position
Preferred
+ 5 years of applying Advance Mathematics OR in an Actuarial OR Risk Management role
LICENSES or CERTIFICATIONS
Required
+ None
Preferred
+ None
SKILLS
+ Deep understanding ofHighmark Health Plan products, services and risk assessment techniques
+ Experience with customer relationship management
+ Consultative and partnership-driven mindset
+ Strong oral and written communication
+ Strong analytical background
+ Focus on team skill development
Language (Other than English):
None
Travel Requirement:
25% - 50%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Frequently
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Occasionally
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 Requirement_ _: This 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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( _https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf_ )
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J250295
Highmark Inc.
Job Description :
JOB SUMMARY
This job is responsible for overseeing end-to-end operations of the designated function within Underwriting, including adherence to timeliness, quality expectations, and applicable internal and governmental regulations. The incumbent communicates daily within the function on work planning, risks, issues, etc and meets routinely with Underwriting leadership to review metrics, performance, and key issues.
ESSENTIAL RESPONSIBILITIES
+ Perform management responsibilities to include, but are limited to, involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
+ Plan, organize, staff and direct and control the day to day operations of the department, develop and implement policies and programs as necessary, may have budgetary responsibility.
+ Manage relationships between assigned function and other key stakeholders. Provide guidance to underwriting functions as a SME to health plan underwriting. Understand strategic and practical impacts of issues and voices concerns when necessary.
+ Ensure integrity and consistent application of Underwriting policies and guidelines for all clients.
+ In exception scenarios, 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.
+ Manage intraday workload planning across the function and escalates long-term concerns to appropriate inter-departmental team.
+ Other duties as assigned or requested.
EDUCATION
Required
+ Bachelor's Degree in Science, Mathematics, Technology or related field
Substitutions
+ 6 years of related underwriting experience in lieu of Bachelor degree
Preferred
+ None
EXPERIENCE
Required
+ 7 years of Health Care Underwriting
+ 5 years in a Leadership position
Preferred
+ 5 years of applying Advance Mathematics OR in an Actuarial OR Risk Management role
LICENSES or CERTIFICATIONS
Required
+ None
Preferred
+ None
SKILLS
+ Deep understanding ofHighmark Health Plan products, services and risk assessment techniques
+ Experience with customer relationship management
+ Consultative and partnership-driven mindset
+ Strong oral and written communication
+ Strong analytical background
+ Focus on team skill development
Language (Other than English):
None
Travel Requirement:
25% - 50%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Frequently
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Occasionally
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 Requirement_ _: This 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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( _https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf_ )
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J250295
Source : Highmark Health