Underwriter II - Large Group (San Jose) ( Job Number: 159080 )
Kaiser Permanente - San Jose, CA

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Underwritings overarching function is to 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
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.
• Implement new and existing policies, procedures, and methodology.
• Implement continuous quality improvement programs.
• Strategize with internal customers on implications of decisions on business outcomes.
• Position Underwriting is an integral partner in the creation of effective business solutions.
• Establish relationships with Sales/Account Management to enhance business potential with purchasers, brokers & consultants.
• Develop solutions that increase credibility with customers & Sales/Account Management and external customers.
• Acquire and exhibit knowledge of the external business environment to add value.
• The Underwriting function impacts the financial results of the region and at this level significant loss could occur to a mid/ large set of groups or book of business that would dramatically impact the regions financials.
• Also makes decisions on how the rates align to overall strategy and makes recommendations to internal stakeholders to provide a better benefit to the customers.
• Majority of time determines rates on straightforward cases and begins to participate in the peer review process.
• Uses systematic approaches to break down problems into tasks and to trace the implications of a situation in a step-by-step way.
• Develops solutions to a variety of problems of moderate to complex scope and complexity using judgment within policy and practice guidelines.
• Assesses information to identify the best solution from existing alternatives.
• Customers, Brokers, Consultants and Internal Follows established policies and procedures.
• Works under general supervision.
• Exercises discretion in rating decisions.
• Has some authority to make decisions on changing rates.
• Participates in determining objectives of assignment.
• Participates with peers, team, internal partners, supervisor or manager in problem solving.
• Participates in QA process as both one whose work is reviewed and as a peer reviewer for team members.
• Participates in case reviews with internal partners when appropriate.
• May coach and act as a mentor to peers or less experienced or skilled staff.

Basic Qualifications
Two (2) or more years in rating, underwriting, or a related field required.
• Minimum of four (4) years experience in large group health underwriting required.
• Three (3) to five (5) years of underwriting experience preferred.
• Bachelor's degree in mathematics, statistics, business administration, or a related field or applicable related work experience preferred.
• Excellent written and verbal communication skills.
• Excellent problem-solving skills, particularly financial and statistical.
• Ability to interpret client-specific data to analyze underlying causes of significant changes in demographics and utilization.
• Strong understanding of trends in the insurance industry in California and the practices of competitive carriers.
• Ability to adjust conflicting priorities to meet or exceed established department turnaround goals.

Kaiser Permanente - 20 months ago - save job - block
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OVERVIEW America’s leading not-for-profit health plan, Kaiser Permanente serves more than 9 million people from 37 hospitals and 611...