This position is responsible for financial analysis, monitoring, reporting, risk management and forecasting related to all aspects of the Region’s insurance business. This includes group insurance, cost plus plans, ASO-Self Funded plans and groups. This position is charged with monitoring, analysis and financial reporting for the Joint Venture Partners and Management Committees. This position is responsible for all aspects of underwriting for experience rated business, and direct management /supervision of two (2) regional group underwriters.
Nature & Scope
This position reports directly to the Regional Executive in Central Region.
Rising health care costs and changes in the health care industry over the last few years have created a more competitive marketplace and a changing environment in order to meet the needs of the customer. The strategic direction was to regionalize, to put more jobs and people out in the community, so that we can be close to our customers. The environment of this job is one of teamwork with the other Regional employees, Actuarial and Enterprise Underwriting to provide accurate analysis and management for the region, our customers, and other internal personnel.
The RFRM is self-directed to develop analytical processes and reports, monitor, and forecast for the Region’s insurance business. The incumbent will also receive direction from the Regional Executive and participate as a member of the Region’s management team. Also, work flow is generated through renewal and new sales activity from the marketing staff. The RFRM is accountable for the implementation and application of sound rating principles – utilizing various statistical data to accurately develop, evaluate and adjust rates. The primary underwriting responsibilities are for those employer groups with 51+ employees, our experience rated business.
Generally, the incumbent is self guided, and must be innovative with regard to planning and organizing to accomplish multiple demands and tasks. Additionally, this position is guided by the needs and inputs of marketing efforts, Regional Executives, Joint Venture partners, Enterprise Underwriting, Enterprise Actuaries, policy and legislative concerns and developing healthcare industry trends.
The RFRM must respond to and maintain sound risk management of the Region’s insurance business including Group, self funded, etc. The incumbent must utilize existing reporting information, develop region specific reporting, develop Joint Venture analytical and financial reporting, analyze region financial performance, forecast regional results and participate in regional financial based decision. Utilizing advanced underwriting techniques, the incumbent will manage the risk assessment for the experience rated group insurance.
This position’s principal contacts are within the Region and within the Corporation, the Enterprise Underwriting staff, the Actuarial Division, Customer Accounts, USAble Systems, Customer Service, Legal and Claims, including all levels of management. The incumbent’s principal contacts outside the company are Joint Venture partners, Group Administrators, Sales Agents and other group customers.
The incumbent has the authority to develop and maintain a function to monitor, assess, analyze and report on the Region’s business. This includes implementation of sound underwriting analysis, accurate financial analysis, timely, accurate regional financial reporting, forecasting for products, joint venture results and Region results, recommending appropriate corrective action.
Knowledge, Skills and Abilities
1. Excellent interpersonal skills.
2. Ability to communicate effectively both orally and in writing, including ability to speak to large groups or directly with customers as the “technical expert”.
3. Decision making skills based on sound evaluation and analytical processes.
4. Ability to pass in-house training courses, on-line courses through Blue & You University or any other training deemed necessary or beneficial by Enterprise Underwriting or the Regional Executive.
5. Must dress, conduct and present self in a positive, professional and courteous manner at all times.
Minimum Job Requirements
1) Bachelor degree in mathematics, statistics, finance, accounting or related field, Actuarial studies a plus - Advanced Degree desirable.
2) Experience in group underwriting/actuarial or related field, specializing in large group and advanced underwriting risk assessment.
3) Extensive experience working with personal computers, to include Microsoft Office software that involves spreadsheets (Excel), databases (Access) and word processing (Word).
4) Successful completion of the Supervisor Assessment Center.
5) Full knowledge and understanding of group insurance products, funding, rating, and financial profit/loss principles.
6) Basic knowledge of MemBRS, Decision Power, GCPS (Claims Solution), Data Warehouse, and Enterprise workflow processes is helpful.
7) Ability to comprehend State, Federal and industry regulations and guidelines related to PPACA, underwriting and rating techniques.
This position is identified as level three (3). This position must ensure the security
and confidentiality of records and information to prevent substantial harm, embarrassment,
inconvenience, or unfairness to any individual on whom information is maintained.
The integrity of information must be maintained as outlined in the company Administrative
Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented
or detected on a timely basis by employees in the normal course of business. This
position must adhere to the segregation of duties guidelines in the Administrative
PRINCIPAL ACTIVITIES OR ACCOUNTABILITIES (Essential Functions of Job)
1) Develop reporting of regional financial results and utilization of existing enterprise reports to assist management control of regional financial results.
2) Monitor financial status of all product lines of regional business, providing information to respond quickly and accurately to changing conditions.
3) Develop and present Joint Venture reporting to Joint Venture Management with emphasis on product results.
4) Develop sufficient and competitive rates for new experience rated groups while providing financial management of the regional block of business.
5) Provide renewal ratings for all in force experience rated business while providing financial management of the regional block of business.
6) Provide group reports and exhibits to existing groups including ERISA reporting, financial settlements and experience utilization reports.
7) Participate and assist marketing personnel in “team selling” by meeting with existing and prospective customers, acting as a consultant for large group rating explanations and for consumer directed health plans.
8) Forecasting of regional results, trends and changing environment, acting as the lead for projections utilized in the budgeting of regional results in coordination with Actuarial personnel.
9) Participate as a member of the Region Management team acting as the lead on financial matters.
10) Ability to provide effective management/supervision and training to direct reports.
11) Ability to motivate and mentor direct reports, and to assist them with continuous development and growth in their job knowledge, techniques and the desire to excel.
12) Ability to conduct Performance Evaluations.
13) Other duties and projects as assigned by the Regional Executive.
Arkansas Blue Cross and Blue Shield - 24 months ago
In 2012, Arkansas Blue Cross was named one of central Arkansas’ “Top Work Places” by the Arkansas Democrat-Gazette and...