Provides underwriting and/or rates analytic support. Develops & quotes rates for assigned employer groups, checks benefits & rates entered into computer system, & provides analysis on rates & rating issues. May lead or act as a resource to lower level Rates Analysts. Duties may vary based on assigned groups and/or lines of business. Maintain & support a culture of compliance, ethics & integrity. Responsible for ensuring ongoing compliance for Pricing & Underwriting. Maintains knowledge of policies & procedures & performs in accordance w/ applicable regulatory requirements, external laws & accreditation standards as they relate to for Pricing & Underwriting.
Essential Functions:
- Develop & quote rates & coordinate rate renewals for employer groups. Analyze regulatory requirements, implements changes & makes decisions regarding underwriting guidelines
- Check & approve rates for employer groups as they renew their contracts or as changes occur & are entered on the computer system. Evaluate individual health questionnaires for accept/decline of risk. Monitor 'accept & reject' ratios to ensure a balanced risk profile
- Influence the positioning of KP within accounts & within the line of business overall in a manner that supports a balanced risk profile
- Support sales & account management staff in the new business, renewal, & customer management process, including engaging in consultative selling, as a technical expert, & through support of balanced membership growth. Support Colorado Springs underwriting as required
- Support the interests & strategies of Denver/Boulder in the Colorado region & promote initiatives that benefit the region as a whole. Represent the market & the region w/ clients, brokers, consultants, & other external parties. Support the development, compilation, & communication of marketplace positioning & trends at the group, line of business, & carrier levels
- Educates Sales-Account Management on improving field underwriting & risk management.
Support (directly as a coordinator/project manager, directly as a participant, indirectly by providing suggestions, & indirectly by supporting implementation) the development of best practices in the pricing & underwriting organization
- Advise other departments & staff on rating policies & procedures
- As a resource to staff (if assigned), manage day to day priorities & facilitate problem solving. Facilitate staff and/or other regular underwriting meetings & processes. Monitors agreed upon team objectives & participate in performance reviews for all team members. Participate in developing & monitoring department budget
- Leads underwriting special projects. Ensure reports are generated, analyze results, identify areas for improvement, work w/ team members to create solutions, implement & monitor
- Facilitate & manage Rate Review meetings & processes
- Maintain knowledge of & compliance w/ all federal & state insurance laws & regulations that affect applicable underwriting practices. Ensures all quoted rates & rating practices align w/ DOI rate filings, & if applicable, FEHBP guidelines. Seeks management input in cases that compliance ambiguity exists
- In addition to defined technical requirements, accountable for consistently demonstrating service behaviors & principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives
- Also accountable for consistently demonstrating the knowledge, skills, abilities, & behaviors necessary to provide superior & culturally sensitive service to each other, to our members, & to purchasers, contracted providers & vendors
Qualifications:
Basic Qualifications:
- Depending on assigned line of business, must have :
Knowledge of actuarial rating concepts with :
- A minimum of 4 year's experience w/ developing group rates & performing various financial analysis in a managed care environment. (large groups/pricing)
- A minimum of 4 years of progressive experience managing a product segment or business. Specifically, ensuring compliance w/ legal/regulatory requirements, analyzing product portfolio including pricing, & evaluating the marketplace. (small business unit)
- Bachelor's degree or equivalent experience in economics, business, marketing, mathematics, statistics, or related field
- Knowledge of insurance regulatory requirements & filings, as required by assigned line of business.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.