About the Role
This role involves assessing insurance and healthcare coverage proposals for national accounts, determining risk levels, and supporting underwriting decisions through data analysis and financial modeling.
Responsibilities
- Analyze healthcare cost trends and claims data to assess risk for large employer groups
- Review coverage proposals and recommend pricing strategies based on actuarial models
- Collaborate with account management teams to understand client needs and constraints
- Prepare detailed underwriting reports for senior review and client presentations
- Ensure compliance with federal, state, and regulatory requirements in all submissions
- Evaluate provider network impacts on cost and coverage for national clients
- Support renewal processes by analyzing historical performance and utilization patterns
- Identify opportunities to improve underwriting accuracy and operational efficiency
- Work cross-functionally with actuarial, legal, and finance departments on complex cases
- Maintain up-to-date knowledge of healthcare reform and industry regulations
- Develop risk segmentation models to differentiate client pricing tiers
- Assist in the design of customized benefit structures for large groups
- Monitor changes in client demographics and workforce composition
- Validate data integrity across internal and external reporting systems
- Present findings and recommendations to internal stakeholders
- Respond to requests for proposal with accurate financial projections
- Track underwriting pipeline and submission timelines for national accounts
- Ensure documentation meets audit and compliance standards
- Participate in process improvement initiatives for underwriting workflows
- Support training efforts for new team members on underwriting protocols
Nice to Have
- Master’s degree in a quantitative or healthcare-related field
- Five or more years of underwriting experience in healthcare
- Direct experience with Medicare Advantage or Medicaid populations
- Advanced skills in predictive modeling or risk scoring
- Project management experience in a corporate setting
- Familiarity with value-based care arrangements
- Experience presenting to executive-level audiences
- Knowledge of pharmacy benefit structures and utilization
- Certified Risk Manager (CRM) or similar credential
- Prior work with integrated delivery systems
Compensation
Competitive salary with performance-based incentives and comprehensive benefits package.
Work Arrangement
Hybrid work model with a combination of remote and office-based days.
Team
Part of a national underwriting team focused on strategic client partnerships and data-driven decision making.
Why This Role Matters
Your analysis directly influences how healthcare coverage is structured for thousands of members, balancing affordability with sustainability. You’ll help shape equitable pricing models while supporting long-term client relationships across diverse industries.
Growth Opportunities
Team members have pathways to advance into senior underwriting, actuarial roles, or strategic account leadership. Internal mobility is encouraged, with access to mentorship and professional development programs.
