The VP of Stop-Loss Underwriting will lead the Stop-Loss Underwriting team at Cambia Health Solutions, managing risk selection and classification to meet growth and profitability goals. This role involves strategic oversight of underwriting policies, rate development, and leadership of a team of underwriters and analysts, all while ensuring compliance and innovation in a remote work environment.
What You'll Do
- Manage stop loss book of business risk selection and risk classification activities to meet top line growth and bottom-line profitability objectives
- Serve as Cambia-wide final decision maker for stop loss concessions on rates and terms prior to escalation
- Plan, develop and direct the activities of the Underwriting Stop Loss departments within Cambia
- Meet corporate objectives for stop loss risk management, renewal activity, and new business production
- Secure necessary capabilities for stop loss business including premium and billing system, reporting system, UM/CM capabilities in/outsourced
- Actively engage with state insurance departments to initiate and/or resolve filing issues
- Drive process to evaluate and approve external Third-Party Administrators
- Represent Cambia and CBRM in AM Best presentations
- Develop strategies to meet the corporate goals for contribution to reserves by line of business through rating, reimbursement and risk management strategies
- Establish quote authority limits for all stop loss underwriters
- Review and sign-off on all cases above the underwriter's quote authority limits and all exception cases
- Be responsible for the development and maintenance of the Underwriting Guidelines
- Conduct annual stop loss underwriting audits of all underwriters
- Provide oversight of the stop loss contracts
- Direct development and implementation of policies and procedures in compliance with corporate strategies and legislative mandates
- Direct the development and application of equitable and competitive rates to group to assure favorable underwriting
- Direct the development and implementation of underwriting policies that preclude adverse selection and provide the opportunity of coverage to specified communities
- Maintain an optimum balance between an adequate rate structure and stop loss coverage that is competitive in the marketplace
- Provide support and analysis to the Senior Vice President and Chief Actuarial Officer
- Monitor and recommend changes to manual rate and factor development to ensure optimal outcomes for sales, renewals, and underwriting gain
- Lead a team of Managers, Stop Loss Underwriters, Stop Loss Claims Analysts, Medical Risk Consultants and support personnel
- Direct work product and production of assigned stop loss underwriting nurse staff
- Demonstrate ability to read the self-funded employer stop loss marketplace with regards to rate sensitivity and product offerings
- Apply in-depth knowledge of the health care industry and specifically in the self-funded employer stop loss market
- Think analytically, apply analytical techniques and provide in-depth analysis and recommendations using critical thinking and sound judgment
- Apply and interpret quantitative data for decision-making
- Work with complex computer software systems
- Communicate complex mathematical concepts to lay personnel
- Communicate effectively, verbally and in writing, with all levels of the workforce
- Establish and maintain effective working relationships with executives, managers, supervisors, sales professionals and brokers
- Work with all levels of the staff and management both as a self-starter and in a team environment
- Promote new visions and ideas and gain 'buy in' from senior leadership, management and peers
- Plan, organize and lead the work of others with minimal supervision
- Develop departmental goals and objectives consistent with corporate vision and strategies
- Coach and develop Stop Loss Underwriting Managers
- Leverage AI tools and resources to drive efficiency and innovation within area of expertise
What We're Looking For
- Bachelor's degree in business, math, statistics or related discipline
- 12+ years underwriting experience in the health insurance profession with specific responsibilities in stop loss
- Demonstrated ability to read the self-funded employer stop loss marketplace with regards to rate sensitivity and product offerings
- In-depth knowledge of the health care industry and specifically in the self-funded employer stop loss market
- Demonstrated competency to think analytically, apply analytical techniques and to provide in-depth analysis and recommendations using critical thinking and sound judgment
- Demonstrated competency to apply and interpret quantitative data for decision-making
- Demonstrated competency working with complex computer software systems
- Strong knowledge with complex mathematical concepts and ability to communicate abstract concepts to lay personnel
- Demonstrated competency in effective communication, verbally and in writing, with all levels of the workforce
- Demonstrated competency to establish and maintain effective working relationships with executives, managers, supervisors, sales professionals and brokers
- Demonstrated ability to work with all levels of the staff and management both as a self-starter and in a team environment
- Demonstrated ability to promote new visions and ideas and gain 'buy in' from senior leadership, management and peers
- Strong knowledge in planning, organizing and leading the work of others with minimal supervision
- Ability to coach and develop Stop Loss Underwriting Managers
- Demonstrated ability to leverage AI tools and resources to drive efficiency and innovation within area of expertise
Technical Stack
- AI tools and resources
- complex computer software systems
- premium and billing system
- reporting system
- UM/CM capabilities
Team & Environment
- Team size: 8-12 FTEs
- Structure: Managers, Stop Loss Underwriters, Stop Loss Claims Analysts, Medical Risk Consultants, support personnel, and stop loss underwriting nurse staff
- Reports to: Senior Vice President and Chief Actuarial Officer
- Purpose-driven culture focused on innovation and sustainable, person-focused health care
- Award-winning culture built on trust and innovation
- Caring and supportive colleagues
- Compassion, empathy and team spirit
- Diverse teams building solutions
- Commitment to helping employees succeed
- Community outreach participation
- Employee resource groups
- Career is more than just a paycheck
Benefits & Compensation
- Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits
- Annual employer contribution to a health savings account
- Generous paid time off varying by role and tenure
- 10 company-paid holidays
- Market-leading retirement plan including a company match on employee 401(k) contributions
- Potential discretionary contribution based on company performance (no vesting period)
- Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave)
- Award-winning wellness programs that reward you for participation
- Employee Assistance Fund for those in need
- Commute and parking benefits
- Work from home options for most of our roles
- Internet service with a minimum upload speed of 5Mb and a minimum download speed of 10Mb required for remote work
- Compensation: $238,900.00 – $323,200.00 (expected hiring range); current full salary range is $224,000.00 – $366,000.00
- Bonus target of 31.25%
Work Mode
- Work from home options available
- Requires wired internet connection (not satellite or cellular) with minimum upload speed of 5Mb and download speed of 10Mb
We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected].
