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Senior Underwriter Alternate Funding

1 month ago

Denver, United States Kaiser Permanente Full time

Salary Range: $42.02/hour - $49.42/hour

Job Summary: Join our Underwriting Alternate Funding team This position will support Underwriting Alternate Funding, which includes Self-Funding, Level Funding, and Risk Sharing Arrangements. Alternate Funding is growing due to the expansion of Level Funding in many of our regions and work is underway for ongoing development and enhancement of Self-Funding. Evaluates standard and nonstandard data to understand premium, claim, exposure, and population. Independently identifies and escalates actionable data insights/irregularities, researching solutions. Contributes to the creation/use/documentation of models, tools, and assumptions that support business strategy analysis and risk management. Identifies and escalates issues with the implementation of quality and process improvement efforts. Works in support of department initiatives, program, and enterprise goals. With minimal guidance, assesses risk of accounts. Leverages foundational knowledge of the external business environment. With minimal guidance, presents renewal recommendations to clients/organization. Independently collaborates internally to develop case/investment strategies. Independently develops rates and account plans that mitigate risk. Contributes to rate negotiations with external parties. Independently helps customers understand underwriting approach. Addresses data needs and requests. Builds relationships and influences outcomes with customers and channel partners. Independently works with internal partners to bring financial solutions to customers. Provides self/peer review of cases. Maintains compliance with relevant policies, guidelines, and procedures.

Essential Responsibilities:

Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.

Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.

Analyzes and reports on data by: evaluating standard and nonstandard data to understand premium, claim, exposure, and inform understanding of population risk, with little to no guidance; applying comprehensive foundational knowledge to evaluate credibility, utilization, and risk based on population size and prior predictive behavior of the pool/account; independently identifying and escalating actionable insights and potential data irregularities and researching solutions; applying standard concepts and strategies to contribute to the creation and use models (e.g., rate models and benefit pricing tools) and data analytics tools that support the analysis of business strategy and financial/underwriting risk management; and consistently documenting models, tools, assumptions, and data elements for increasingly complex accounts, as required.

Completes case and underwriting work by: processing renewal activities (e.g., running reports, re-quotes, investments, sold rates) for customers and/or book of business under limited supervision; in collaboration with internal departments, independently developing rates that appropriately mitigate risk for the organization and optimize sustainable membership growth; independently developing and executing an account plan that addresses threats and opportunities to ensure attainment of goals in collaboration with Sales and Account Management; exercising judgment during rate negotiations with external parties (e.g., brokers, consultants, and customers); and representing Underwriting in partnership with internal and external partners to co-create effective consultative solutions (e.g., case strategy, investment strategy, benefits strategy).

Contributes to case review and preparation by: conducting account risk assessment using competitive analyses, broker behavior, network cost profiles, legislative and regulatory impacts, revenue requirements, and contributions, with minimal guidance, especially when working on complex cases; utilizing data and standardized tools to present underwriting and renewal actions and recommendations (e.g., rate drivers, potential risk, glide path, membership impact, projections for future) to clients and/or the organization, with minimal guidance; developing, applying, and expanding foundational knowledge of the external business environment and how it applies to the line of business and/or region; and independently collaborating with Sales and Account Management to develop case/investment strategies and recommendations with appropriate documentation.

Engages with the external market by: independently helping the market/customers understand the underwriting approach (e.g., rating methodology, rate drivers, reporting capabilities, and uniqueness from fee for service carriers); addressing data needs and requests reactively and proactively, as they arise; building relationships and influencing outcomes with customers and channel partners that enable them to understand KPs value; and independently collaborating with account management and sales partners to bring strategic, financial solutions to customers, communicate product capabilities, explain funding arrangements, and negotiate conditions of offering and pricing within the limits of their authority.

Contributes to goals, initiatives, and program development efforts by: identifying and escalating issues with implementation of innovative new quality and process improvement efforts; and executing their work in support of department initiatives, program goals, and enterprise goals.

Ensures compliance of Underwriting work by: providing self/peer review of cases, as required, to ensure accuracy and appropriateness of quotes and incorporating feedback from others; appropriately obtaining and documenting case approvals and any policy exceptions and investments; making investment decisions within their authority and escalating to the appropriate level, as needed; and maintaining awareness of and compliance with all relevant policies, guidelines, and procedures, applying them to their own work.

Minimum Qualifications: Bachelors degree in a related field AND minimum two (2) years of experience in Underwriting, Marketplace Evaluations, Financial Analysis, or a related field OR Minimum five (5) years of experience in Underwriting, Marketplace Evaluations, Financial Analysis, or a related field.

Additional Requirements: Knowledge, Skills, and Abilities (KSAs): Business Acumen; Negotiation; Applied Data Analysis; Data Quality; Financial Modeling; Interpersonal Skills; Organizational Skills; Presentation Skills; Insurance; Claim Analysis; Actuarial Techniques and Principles; Microsoft Office

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