Job Description
A Brief Overview
The Underwriting Manager is responsible for overseeing and executing underwriting functions to support the Avera Health Plans product offerings. This role involves assessing risk, developing rate methodologies, and ensuring compliance with regulatory requirements. The Underwriting Manager will work collaboratively with internal stakeholders such as product, sales, and finance.
What you will do
- Develop and implement underwriting guidelines, processes, and procedures.
- Analyze and evaluate risk factors to establish appropriate premium rates.
- Review and approve underwriting decisions within designated authority limits.
- Conduct risk assessments for group and Medicare Supplement health plan accounts.
- Provide insights on risk profiles and recommend strategies to mitigate adverse selection.
- Support the development of underwriting models in collaboration with internal/external actuarial services.
- Partner with sales and marketing teams to support new business opportunities and renewals.
- Provide detailed analysis and reporting on underwriting decisions to internal stakeholders and prepare regular reports on underwriting performance and risk trends for leadership review.
- Work with the compliance team to ensure adherence to regulatory standards and Identify opportunities to enhance underwriting processes and implement best practices.
- Analyze claims experience and trends to inform underwriting decisions and contribute to forecasting and budgeting processes by providing underwriting insights.
Essential Qualifications
The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
Job Requirements
Required Education, License/Certification, or Work Experience:
Bachelor's in business, finance, actuarial science, or a related field.
Preferred Education, License/Certification, or Work Experience:
Master's in business, finance, actuarial science, or a related field.
Associate of the Society of Actuaries (ASA) - Society of Actuaries (SOA) Upon Hire or
Fellow of the Society of Actuaries (FSA) - Society of Actuaries (SOA) Upon Hire or
Registered Health Underwriter (RHU) - The American College of Financial Services Upon Hire or
Certified Risk Manager (CRM) - The National Alliance for Insurance Education & Research Upon Hire
4-6 years Experience in health insurance underwriting, with a focus on risk assessment.
Comprehensive knowledge of health plan operations, products, and regulations.
Strong analytical skills and proficiency in data analysis tools (e.g., Excel, SQL)
Experience collaborating with internal/external actuarial services and sales departments
Expectations and Standards
Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
Promote Avera’s values of compassion, hospitality, and stewardship.
Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.